内容紹介
Surgical Resection of a Huge Gastric Gastrointestinal Stromal Tumor after Preoperative Adjuvant Chemotherapy
Summary
A 73-year-old man was referred to our hospital because of positive results on a fecal occult blood test. He had severe anemia, and abdominal computed tomography(CT)revealed a huge 18×11 cm tumor in the lower gastric corpus. Pathological analysis of a biopsy sample revealed a gastrointestinal stromal tumor(GIST). We improved the nutritional and physical statuses via total parenteral and enteral nutrition. At the same time, we initiated preoperative adjuvant chemotherapy with 300 mg/day of imatinib. After 4 weeks' of treatment, CT revealed a drastic reduction in the tumor size, regarded a partial response(PR). The patient underwent partial gastrectomy, distal pancreatectomy, and partial resection of the transverse colon. His postoperative course was uneventful. The patient received postoperative treatment with imatinib for 1 year, and remained recurrence free for 10 months after surgery.
要旨
症例は73歳,男性。便潜血陽性の精査にて高度貧血,腹部CTで胃体下部に18×11 cmの巨大腫瘍を認め入院となった。上部内視鏡検査による生検でGISTと診断された。低栄養,全身状態不良のため,中心静脈栄養と経管栄養を行って状態の改善を図る必要があり,この間術前化学療法としてイマチニブ300 mg/dayを投与した。約4週間投与後の腹部CTで腫瘍の縮小を認めPRと判定,貧血と全身状態は改善し手術施行となった。胃部分切除,膵体尾部脾切除,横行結腸部分切除を施行した。退院後,1年間のイマチニブによる術後補助化学療法を行っており,術後10か月の現在再発は認めていない。
目次
Summary
A 73-year-old man was referred to our hospital because of positive results on a fecal occult blood test. He had severe anemia, and abdominal computed tomography(CT)revealed a huge 18×11 cm tumor in the lower gastric corpus. Pathological analysis of a biopsy sample revealed a gastrointestinal stromal tumor(GIST). We improved the nutritional and physical statuses via total parenteral and enteral nutrition. At the same time, we initiated preoperative adjuvant chemotherapy with 300 mg/day of imatinib. After 4 weeks' of treatment, CT revealed a drastic reduction in the tumor size, regarded a partial response(PR). The patient underwent partial gastrectomy, distal pancreatectomy, and partial resection of the transverse colon. His postoperative course was uneventful. The patient received postoperative treatment with imatinib for 1 year, and remained recurrence free for 10 months after surgery.
要旨
症例は73歳,男性。便潜血陽性の精査にて高度貧血,腹部CTで胃体下部に18×11 cmの巨大腫瘍を認め入院となった。上部内視鏡検査による生検でGISTと診断された。低栄養,全身状態不良のため,中心静脈栄養と経管栄養を行って状態の改善を図る必要があり,この間術前化学療法としてイマチニブ300 mg/dayを投与した。約4週間投与後の腹部CTで腫瘍の縮小を認めPRと判定,貧血と全身状態は改善し手術施行となった。胃部分切除,膵体尾部脾切除,横行結腸部分切除を施行した。退院後,1年間のイマチニブによる術後補助化学療法を行っており,術後10か月の現在再発は認めていない。