イマチニブ ガ チョコウ シ チョウキ カンゼン カンカイ CR オ イジ シテ イル ショウチョウ GIST フクマク ハシュ サイハツ ノ 1レイ
A case of recurrent gastrointestinal stromal tumor with peritoneal dissemination in which long-term complete remission was achieved with imatinib mesylate therapy
Masamune, Katsuhiro Department of Surgery, Anan Kyoei Hospital
Toyota, Tsuyoshi Department of Surgery, Anan Kyoei Hospital
Takamura, Kazuhito Department of Surgery, Anan Kyoei Hospital
Kita, Yoshitaka Department of Surgery, Anan Kyoei Hospital
Sannomiya, Kenji Department of Surgery, Anan Kyoei Hospital
gastrointestinal stromal tumor （GIST）
We report the case of a patient with recurrent gastrointestinal stromal tumor （GIST） complicated with peritoneal dissemination who achieved long-term complete remission （CR） with imatinib mesylate therapy. A 64-year-old man was admitted to our hospital because of severe abdominal pain. Abdominal computed tomography （CT） showed free air and an intra-abdominal abscess. Perforation of the small intestine was diagnosed, and an emergency operation was performed. Two adjacent tumors （each,6cm in size）, one of which was ruptured, were found by laparotomy in the jejunum and as a peritoneal dissemination. Jejunojejunostomy with the two adjacent tumors was performed and as much of the disseminated tumors as possible were resected. Histopathological analysis indicated a high-risk GIST of the small intestine.
Abdominal CT at 1.5 years after the initial operation showed multiple recurrent tumors due to peritoneal dissemination. The patient subsequently received imatinib mesylate therapy at 400mg/day, and 5 months later, abdominal CT showed no evidence of tumor recurrence. DNA analysis of the tumor revealed an exon 11 mutation in the c-kit gene. The patient continues to receive imatinib mesylate therapy （400mg/day）, and CR of the recurrent tumors has been maintained for 8 years and 7 months.
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