Libyan Journal of Medicine
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Successful Surgical Resection of Advanced Gastrointestinal Stromal Tumor Post Neoadjuvent Therapy
SM Kamil 1, M Biswas 1, AK Imran 1, R Islam 1, AA Mukhtar 1, SC Joshi 1
1 - Advanced Medical and Dental Institute (Clinical Centre), Universiti Sains Malaysia, Penang, Malaysia
Libyan J Med 2009; 4(2):83-85
ICID: 881112
Article type: Case report
IC™ Value: 2.33
Abstract provided by Publisher
 
We report a case of a 48-year-old Indian male who presented with swelling and firmness in his left
upper part of the abdomen of one month duration with anorexia and weight loss. Initial examination
revealed an intra abdominal mass of around 16.8x11.0x24.5cm with minimal left sided pleural
effusion. A biopsy from the mass confirmed the diagnosis of gastrointestinal stromal tumour (GISTs)
as supported by immmunohistochemistry results which showed strong positivity for c-kit while stains
for smooth muscle actin, desmin, myoglobin, S100 Protein and cytokerstin remained negative. The
patient was not suitable for surgical intervention in view of advanced tumor, and Imatinib Mesylate
400mg daily was started with the aim of making the tumor operable. Such therapy lasted for twenty
months and was tolerated well by the patient. It then resulted in gradual tumor regression, following
which the patient underwent successful tumor resection. Post surgical resection patient had no
radiological evidence of intra abdominal tumor but mild left sided pleural effusion with left lower lobe
atelectasis. The patient had uneventful post operative recovery and he is currently on Imatinib
mesylate and tolerating treatment well with mild skin rash. The experience with preoperative imatinib
on surgical resection rates and post operative outcomes is limited especially with primary locally
advanced GISTs. In our case successful surgical resection was possible for a huge locally advanced
GIST with unusually prolonged treatment of twenty months with imatinib preoperatively.

ICID 881112

DOI 10.4176/081220
 
FULL TEXT 300 KB


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