Recurrent rectal GIST resected successfully after preoperative chemotherapy with imatinib mesylate

A 60-year-old-man underwent initial resection of a rectal tumor, with a transanal approach, on December 6, 2000. The tumor was diagnosed as a gastrointestinal stromal tumor(GIST) by KIT and CD34 immunohistochemistry. In June 2003, a third recurrence in the rectum was discovered, at the same location...

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Bibliographic Details
Published in:International journal of clinical oncology 2008-08, Vol.13 (4), p.355-360
Main Authors: Hamada, Madoka, Ozaki, Kazuhide, Horimi, Tadashi, Tsuji, Akihito, Nasu, Yoshitsugu, Iwata, Jun, Nagata, Yusuke
Format: Article
Language:English
Subjects:
Antineoplastic Agents - therapeutic use
Benzamides
Cancer Research
Cancer surgery
Case Report
Chemotherapy
Clinical outcomes
Colorectal cancer
Combined Modality Therapy
Gastrointestinal Stromal Tumors - drug therapy
Gastrointestinal Stromal Tumors - surgery
Humans
Imatinib Mesylate
Male
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy
Neoplasm Recurrence, Local - drug therapy
Neoplasm Recurrence, Local - surgery
Oncology
Piperazines - therapeutic use
Protein Kinase Inhibitors - therapeutic use
Protein-Tyrosine Kinases - antagonists & inhibitors
Pyrimidines - therapeutic use
Rectal Neoplasms - drug therapy
Rectal Neoplasms - surgery
Surgical Oncology
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Summary:A 60-year-old-man underwent initial resection of a rectal tumor, with a transanal approach, on December 6, 2000. The tumor was diagnosed as a gastrointestinal stromal tumor(GIST) by KIT and CD34 immunohistochemistry. In June 2003, a third recurrence in the rectum was discovered, at the same location as the initial tumor, and he was referred to our hospital. Magnetic resonance imaging (MRI) revealed a tumor 3.0 cm in diameter, compressing the prostate anteriorly. After the oral administration of imatinib mesylate (Gleevec, Glivec) at a dose of 400 mg per day for 3 months, the size of the tumor had decreased to 1.2 cm in diameter. On December 12, 2003, a fourth operation was performed successfully, with a perineal approach, preserving sphincter function. More than 40 months after the fourth operation, neither local recurrence nor distant metastasis was detected. Our strategy of treatment with imatinib allows not only complete excision of the tumor but it also reduces postoperative impediments in patients with recurrent rectal GIST.
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-007-0735-1