A 10-year Survivor after Repeated Hepatectomies, Microwave Coagulation Therapy and Radiofrequency Ablation against Liver Metastases from Gastrointestinal Stromal Tumor

Shinya Nakashima, Kazuo Chijiiwa, Kazuhiro Kondo, Naoki Maehara, Tsuyoshi Takaya, Sayaka Moriguchi* and Yujiro Asada*

Department of Surgery 1 and Department of Pathology 1*, Faculty of Medicine, University of Miyazaki

We report 10-year survival after four hepatectomies for liver metastases in gastrointestinal stromal tumor (GIST). A 69-year-old man who had undergone total gastrectomy, splenectomy, and distal pancreatectomy for GIST in 1990, was found to have a metastatic liver tumor in 1995, necessitating partial hepatectomy. Two additional hepatectomies were conducted for metastatic liver tumors. In 2003 and 2004, the man underwent radiofrequency ablation (RFA) for metastatic liver tumors in hepatic segment VIII after declining further surgery. In 2005, metastatic liver tumors appeared in segments II and IV, necessitating partial resection of corresponding segments and a previously ablated liver segment. A metastatic tumor was also present in resected segment VIII, where RFA had been previously done. Histological diagnosis for the primary tumor had been leiomyosarcoma, and immunohistochemical staining in 2001 showed all specimens to be positive for KIT and CD34, confirming the diagnosis of GIST. Long-term survival is thus possible in repeated hepatectomies in a patient with hepatic metastases from GIST.

Key words
gastrointestinal stromal tumor, liver metastasis, long term survival

Reprint requests
Kazuo Chijiiwa Department of Surgery 1, Faculty of Medicine, University of Miyazaki
5200 Kihara, Kiyotake, Miyazaki, 889-1692 JAPAN

Accepted
February 22, 2006

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