A Case of Gastrointestinal Stromal Tumor of Ascending Colon with a Lymph Node Metastasis

Naoya Yamaguchi, Masaya Shiomi, Yuichiro Tojima, Satoshi Kamiya, Katsutaka Watanabe, Hidehiko Otsuji, Koji Shibata and Junichi Kamiya

Department of Surgery, JA Aichi-Koseiren Toyota Kosei Hospital

A 46-year-old man reporting abdominal pain underwent right hemicolectomy under a diagnosis of ascending colon carcinoma with acute appendicitis. Histopathologically, he had gastrointestinal stromal tumor (GIST) with metastasis to the iliocolic lymph node. The 9 cm in diameter tumor involved the right kidney, and a small part of the tumor remained on the capsule of the kidney. Although we administered postoperative imatinib therapy, he died 10 months postoperatively due to the local recurrence. GIST in the large intestine is rare, accounting for fewer than 10% of all GISTs. Those with small/large intestinal GIST reportedly have shorter median survival (29 months) than those with gastric GIST (46 months). Our case of ascending colon GIST with lymph node metastasis showed aggressive growth, cutting survival to only 10 months despite an imatinib treatment because of the possible acquisition of imatinib-resistance during this therapy. Lymph node dissection in our case had little significance because complete resection of the tumor was impossible.

Key words
gastrointestinal stromal tumor, imatinib, lymph node metastasis

Reprint requests
Naoya Yamaguchi Department of Surgery, JA Aichi-Koseiren Toyota Kosei Hospital
500-1 Ibobara Josui-cho, Toyota, 470-0396 JAPAN

Accepted
April 23, 2008

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