A Case of Malignant Gastrointestinal Stromal Tumor of the Stomach with Dissemination Responding to Imatinib Mesylate after Operation

Yuichi Arimoto, Kohei Ota, Hiroshi Otani and Eui-Chul Kim

Department of Surgery, Osaka City Sumiyoshi Hospital

We report a case of malignant gastrointestinal stromal tumor (GIST) of the stomach with dissemination responding to postoperative administration of imatinib mesylate and enabling survival without recurrence for 21 months. A 49-year-old woman hospitalized for upper abdominal pain was found in abdominal CT to have a protruding tumor about 10 cm in diameter at the lumen of the gastric body. During surgery done after the tumor was diagnosed as of gastric origin, multiple disseminated tumors were detected in the bilateral diaphragm and abdominal wall. The main gastric tumor was resected by partial gastrectomy and all disseminated tumors resected where possible. Histopathologically, the main and disseminated tumors consisted of spindle cells with oval nuclei. The tumor was diagnosed as uncommitted malignant GIST. Although the first choice for treating GIST is surgery, imatinib mesylate may be effectively administered as neoadjvant chemotherapy postoperatively and in recurrent cases.

Key words
gastrointestinal stromal tumor, imatinib mesylate, dissemination

Reprint requests
Yuichi Arimoto Department of Surgery, Osaka City Sumiyoshi Hospital
1-2-16 Higashikagaya, Suminoe-ku, Osaka, 559-0012 JAPAN

Accepted
January 26, 2005

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