A Case of Operation for Gastrointestinal Stromal Tumor of the Stomach with Liver Metastases Responding to Imatinib Mesylate

Takaaki Arigami, Sumiya Ishigami, Tsunayuki Ohtsuka, Shuichi Hokita, Shoji Natsugoe and Takashi Aikou

Department of Surgical Oncology and Department of Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences

A 74-year-old man admitted for appetite loss was found in gastrointestinal fiberscopy to have an elevated tumor with an ulcer on the upper third of the stomach. Pathological examination of the biopsied specimen yielded a diagnosis of gastrointestinal stromal tumor. Multiple liver metastases were suspected from abdominal computed tomography. Deeming curative surgery not possible, we started treatment with imatinib mesylate at a dose of 400 mg/day. After 18 weeks of treatment, the primary tumor, but not liver metastases, showed partial response. Because of severe interstitial pneumonia, we conducted proximal gastrectomy and partial hepatectomy. Histological exploration showed that most of the primary tumor was replaced by fibrotic tissue and some cells remained. Although the recurrence of liver metastases was detected 6 months after surgery, it showed cystic change after chemotherapy with imatinib mesylate. The patient remains alive 13 months postoperatively.

Key words
gastrointestinal stromal tumor, imatinib mesylate, liver metastases

Reprint requests
Takaaki Arigami Department of Surgical Oncology and Department of Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
8-35-1 Sakuragaoka, Kagoshima, 890-8520 JAPAN

Accepted
March 30, 2005

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