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Neoadjuvant imatinib in a gastrointestinal stromal tumor of the rectum: Report of a case

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Abstract

Gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal tract, and of these, GISTs involving the rectum are uncommon. This report describes a case of effective neoadjuvant therapy for a rectal GIST expressing the c-kit gene, where a laparoscopic ultralow anterior resection was successfully performed, thus preserving the anus. A 57-year-old woman visited our hospital due to constipation and was found by a digital examination to have a soft mass on the right wall of the rectum. Computed tomography revealed an 8.0 × 5.0-cm mass with an unclear margin adjacent to the rectum. A biopsy specimen was positive for CD34 and the c-kit gene product, but it was not positive for smooth muscle actin or S-100 protein, and thus the tumor was diagnosed as GIST. An abdominoperineal resection is generally essential for large rectal GISTs; however, she refused this operation. Neoadjuvant treatment with Imatinib decreased the tumor size (4.0 × 3.5 cm) and the anus was preserved by a laparoscopic ultralow anterior resection with direct coloanal anastomosis. She had no evidence of disease for 24 months postoperatively. To preserve the anus, a rectal GIST expressing the c-kit gene is best treated with Imatinib as neoadjuvant therapy.

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References

  1. Meijer S, Peretz T, Gaynor JJ, Tan C, Hajdu SI, Brennan MF. Primary colorectal sarcoma. A retrospective review and prognostic factor study of 50 consecutive patients. Arch Surg 1990;125:1163–1168.

    PubMed  CAS  Google Scholar 

  2. Markku M, Mary F, Maarit SR, Allen B, Leslie HS, Jerzy L. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the rectum and anus. Am J Surg Pathol 2001;25:1121–1133.

    Article  Google Scholar 

  3. Tworek JA, Goldblum JR, Weiss SW, Greenson JK, Appelman HD. Stromal tumors of the anorectum: a clinicopathologic study of 22 cases. Am J Surg Pathol 1999;23:946–954.

    Article  PubMed  CAS  Google Scholar 

  4. Connolly EM, Gaffney E, Reynolds JV. Gastrointestinal stromal tumours. Br J Surg 2003;90:1178–1186.

    Article  PubMed  CAS  Google Scholar 

  5. Hama Y, Okizuka H, Odajima K, Hayakawa M, Kusano S. Gastrointestinal stromal tumor of the rectum. Eur Radiol 2001;11: 2016–2019.

    Article  Google Scholar 

  6. Shibata Y, Tadashi U, Seki H, Yagihashi N. Gastrointestinal stromal tumor of the rectum. Eur J Gastroenterol Hepatol 2001;13: 283–286.

    Article  PubMed  CAS  Google Scholar 

  7. Sarlomo-Rikala M, Kovatich AJ, Barusevicius A, Miettinen M. CD117: a sensitive marker for gastrointestinal stromal tumors that is more specific than CD34. Mod Pathol 1998;11:728–734.

    PubMed  CAS  Google Scholar 

  8. Joensuu H, Roberts PJ, Sarlomo-Rikala M, Andersson LC, Tervahartiala P, Tuveson D, et al. Effect of the tyrosine kinase inhibitor STI571 in a patient with a metastatic gastrointestinal stromal tumor. N Engl J Med 2001;344:1052–1056.

    Article  PubMed  CAS  Google Scholar 

  9. Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 2002;347:472–480.

    Article  PubMed  CAS  Google Scholar 

  10. Wu PC, Langerman A, Ryan CW, Hart J, Swiger S, Posner MC. Surgical treatment of gastrointestinal stromal tumors in the imatinib (STI-571) era. Surgery 2003;13:656–665.

    Article  Google Scholar 

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Ebihara, Y., Okushiba, S., Kawarada, Y. et al. Neoadjuvant imatinib in a gastrointestinal stromal tumor of the rectum: Report of a case. Surg Today 38, 174–177 (2008). https://doi.org/10.1007/s00595-007-3585-6

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  • DOI: https://doi.org/10.1007/s00595-007-3585-6

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