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Laparoscopic resection of a gastrointestinal stromal tumor of the rectum after treatment with imatinib mesylate: report of a case

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Abstract

This report describes the laparoscopic resection of a rectal GIST after treatment with imatinib mesylate. A 56-year-old male presented with a submucosal tumor (longest diameter, 8 cm) arising in the lower rectum. A core needle biopsy revealed that the tumor contained bundles of spindle-like cells. Immunostaining revealed that the tumor was positive for c-kit and CD34. Analysis of the c-kit gene revealed a substitution of ACA (threonine) by GCA (alanine) at codon 574 of exon 11. Imatinib mesylate (400 mg/day) was given as preoperative adjuvant therapy for 3 months, and the tumor shrank to 5 cm in diameter. Proctectomy with transanal anastomosis could be performed laparoscopically, while preserving the anus. There was no evidence of recurrence 2 years 6 months after surgery. Preoperative adjuvant chemotherapy with imatinib mesylate may permit the use of less invasive treatment procedures, allowing anal preservation.

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Acknowledgments

The authors thank K. Yamashita, Department of Pathology, Kitasato University Hospital, for his expertise and technical assistance.

Conflict of interest

Takatoshi Nakamura and the other coauthors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Surgery, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Takatoshi Nakamura, Wataru Onozato, Takeo Sato, Atsushi Ikeda, Masanori Naito, Naoto Ogura, Hiroki Kamata, Akira Ooki & Masahiko Watanabe

  2. Department of Human Pathology, School of Medicine, Juntendo University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Hiroyuki Mitomi

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  1. Takatoshi Nakamura
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  2. Hiroyuki Mitomi
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  3. Wataru Onozato
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  4. Takeo Sato
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  5. Atsushi Ikeda
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  6. Masanori Naito
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  8. Hiroki Kamata
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  9. Akira Ooki
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  10. Masahiko Watanabe
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Correspondence to Takatoshi Nakamura.

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Nakamura, T., Mitomi, H., Onozato, W. et al. Laparoscopic resection of a gastrointestinal stromal tumor of the rectum after treatment with imatinib mesylate: report of a case. Surg Today 42, 1096–1099 (2012). https://doi.org/10.1007/s00595-012-0134-8

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  • DOI: https://doi.org/10.1007/s00595-012-0134-8

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