シル酸イマチニブが奏功した胃原発ｇａｓｔｒｏｉｎｔｅｓｔｉｎａｌ　ｓｔｒｏｍａｌ　ｔｕｍｏｒの術後再発症例

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  • A Case of Postoperative Recurrence due to Gastrointestinal Stromal Tumor of the Stomach Responding to Imatinib Mesylate

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We report a case of a postoperative recurrence of a gastrointestinal stromal tumor (GIST) of the stomach that responded to the administration of imanitib mesylate. A 77-year-old woman who had been hospitalized because of epigastric discomfort was referred to us for the treatment of a submucosal tumor of the cardia that was detected during a gastroscopy examination. The patient underwent a total gastrectomy and splenectomy on June 11, 2001 after being diagnosed as having a gastrointestinal mesenchymal tumor of the stomach. Histo-pathologically, the tumor was composed of a fascicular proliferation of spindle-shaped cells with marked mito-sis. Immunohistochemically, the tumor cells were positive for c-kit and CD34 but negative for actin and s-100. The tumor was diagnosed as a malignant GIST. She was latter readmitted for nausea. A CT examination showed multiple liver metastasis and subphrenic tumors. Treatment with imanitib mesylate at a dose of 400mg/day for 16 days was initiated on June 25, 2002. This dosage was reduced to 200mg/day on July 12, 2002, be-cause of nausea. A CT scan showed rapid tumor shrinkage and cystic changes after 74 days of treatment, the response has continued to date. All toxicities were mild and tolerable. This case suggests that the administra-tion of imanitib mesylate may be an effective treatment for GIST recurrences.

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