Gastrointestinal stromal tumour treated with neoadjuvant imatinib

This report describes a case of unresectable primary gastrointestinal stromal tumour (GIST) treated with imatinib on a neoadjuvant basis, before subsequent successful surgical resection. After six months of imatinib, computed tomography and positron emission tomography imaging demonstrated a signifi...

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Bibliographic Details
Published in:Journal of clinical pathology 2005-07, Vol.58 (7), p.779-781
Main Authors: Loughrey, M B, Mitchell, C, Mann, G B, Michael, M, Waring, P M
Format: Article
Language:English
Subjects:
Aged
Antineoplastic Agents - therapeutic use
Benzamides
Biological and medical sciences
Case Reports
computed tomography
Gastrointestinal Stromal Tumors - diagnosis
Gastrointestinal Stromal Tumors - drug therapy
Gastrointestinal Stromal Tumors - pathology
gastrointestinal stromal tumour
GIST
Humans
imatinib
Imatinib Mesylate
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
neoadjuvant
Neoadjuvant Therapy
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
PET
Piperazines - therapeutic use
Positron-Emission Tomography
Pyrimidines - therapeutic use
Stomach Neoplasms - diagnosis
Stomach Neoplasms - drug therapy
Stomach Neoplasms - pathology
Tomography, X-Ray Computed
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Description
Summary:This report describes a case of unresectable primary gastrointestinal stromal tumour (GIST) treated with imatinib on a neoadjuvant basis, before subsequent successful surgical resection. After six months of imatinib, computed tomography and positron emission tomography imaging demonstrated a significant size reduction and complete metabolic response to treatment, rendering the tumour resectable. Mutational analysis showed an activating KIT mutation in exon 11. The pathological appearance of the resected tumour was heterogeneous with extensive necrosis, cystic and myxoid change, extensive hypocellularity, and patchy foci of residual viable tumour. The implications for this management option of radiological, pathological, and molecular assessment are discussed.
ISSN:0021-9746
1472-4146
DOI:10.1136/jcp.2004.023226