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Giant rectal gastrointestinal stromal tumor successfully resected by abdominoperineal resection combined with posterior vaginal wall resection

  • Iwakawa Kazuhide
    Department of Surgery, National Hospital Organization Fukuyama Medical Center
  • Nishie Manabu
    Department of Surgery, National Hospital Organization Fukuyama Medical Center
  • Tokunaga Naoyuki
    Department of Surgery, National Hospital Organization Fukuyama Medical Center
  • Miyaso Hideaki
    Department of Surgery, National Hospital Organization Fukuyama Medical Center
  • Iwagaki Hiromi
    Department of Surgery, National Hospital Organization Fukuyama Medical Center

Bibliographic Information

Other Title
  • 膣後壁合併切除を伴う会陰アプローチが有用であった直腸巨大GISTの1切除例
  • 症例報告 膣後壁合併切除を伴う会陰アプローチが有用であった直腸巨大GISTの1切除例
  • ショウレイ ホウコク チツコウヘキ ガッペイ セツジョ オ トモナウ エイン アプローチ ガ ユウヨウ デ アッタ チョクチョウ キョダイ GIST ノ 1 セツジョレイ

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Abstract

   We report a case of giant rectal gastrointestinal stromal tumor (GIST) successfully resected by abdominoperineal resection combined with posterior vaginal wall resection. Our patient was a 79-year-old woman had been diagnosed as having von Recklinghausen disease at the age of 30 years. In 2006, a computed tomography (CT) scan revealed a tumor originating from the posterior wall of the rectum. In June 2010, she was admitted to our hospital with the chief complaint of bloody stool. A CT scan revealed a giant tumor that had increased to 9cm in size. Colonoscopy demonstrated a submucosal tumor, which was subsequently diagnosed by biopsy as a GIST. Due to the patient's continuous bleeding and abdominal pain, an emergent abdominoperineal resection was performed at that time. The tumor, which measured 8×9cm, was immunohistochemically positive for c-kit and CD34. Concomitant resection of the posterior wall of the vagina via the perineal approach provided a wide area to expose the tumor for a safe operation. The patient has been well with no sign of recurrence since the operation. This procedure is recommended as a useful approach for giant rectal GISTs or rectal cancer with invasion of the posterior pelvic wall.

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