A COMPLETE RESPONSE TO IMATINIB MESYLATE IN A PATIENT WITH MULTILE LIVER METASTASES OF A JEJUNAL GASTROINTESTINAL STROMAL TUMOR

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  • CHIN Shohken
    Department of Surgery, Asakadai Central General Hospital Department of Surgery II, Tokyo Women's Medical University, School of Medicine
  • FUJITA Ryoichi
    Department of Surgery, Asakadai Central General Hospital
  • NARITA Toru
    Department of Surgery II, Tokyo Women's Medical University, School of Medicine
  • KAWA Yoshitetsu
    Department of Surgery II, Tokyo Women's Medical University, School of Medicine
  • MURATA Jun
    Department of Surgery, Asakadai Central General Hospital
  • KAMEOKA Shingo
    Department of Surgery II, Tokyo Women's Medical University, School of Medicine

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  • イマチニブで完全奏効した空腸ｇａｓｔｒｏｉｎｔｅｓｔｉｎａｌ　ｓｔｒｏｍａｌ　ｔｕｍｏｒ肝転移の１例

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Abstract

A 70-year-old man was found to have multiple liver tumors on ultrasonographic examination for abdominal pain and fever, and was introduced to our hospital for further evaluation and treatment. Additional examinations revealed multiple liver metastases of a jejunal submucosal tumor. Surgery was performed in December 2004, and multiple solid tumors in the liver and a mass of 5cm in diameter at the beginning of the jejunum were found. Partial resection of the jejunum was performed to remove the main jejunal tumor. Histopathological findings revealed fascicular proliferation of spindle-shaped cells in the tumor. Innunohistochemical findings demonstrated that the tumor cells were positive for c-kit, and negative for SMA and S-100. The pathological diagnosis was gastrointestinal stromal tumor (GIST). The patient was given imatinib mesylate at a dose of 400mg/day to treat liver metastases. CT scans and ultrasonographic examination obtained three and a half months after the treatment with imatinib mesylate showed that the hepatic metastatic lesions had disappeared. There are no further signs of recurrence as of 7 months after the drug regimen. Complete response of GIST to imatinib mesylate is rare. We report this patient with liver metastasis of jejunal GIST which responded to the medication completely after the resection of the jejunal tumor.

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