A CASE OF GASTROINTESTINAL STROMAL TUMOR OF THE RECTUM WITH REPEATED LOCAL RECURRENCE AND METACHRONOUS LIVER METASTASIS

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  • 局所再発を繰り返し異時性肝転移をきたした直腸ｇａｓｔｒｏｉｎｔｅｓｔｉｎａｌ　ｓｔｒｏｍａｌ　ｔｕｍｏｒの１例

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Abstract

We report a case of gastrointestinal stromal tumor (GIST) of the rectum with several local recurrences and metachronous hepatic metastasis. An 82-year-old woman was admitted to the hospital because she was found having a hepatic tumor. She had undergone transsacral resection of rectal leiomyosarcoma at the age of 61; had experienced four local recurrences during 18 years thereafter; and had undergone abdominoperineal resection for the recurrent tumor at the age of 79, when GIST of the rectum was diagnosed. After admission, diagnostic imaging revealed two hepatic metastatic tumors (S3; 30mm in diameter, S4; 10mm). We performed hepatic partial resection for each tumor. Pathological diagnosis was liver metastasis from the rectal GIST and immunohistochemical study showed the tumor cells were positive for CD34 and c-kit and negative for SMA, desmin, and NSE. The immunohistochemical results were the same as pathological finings of the rectal tumor. This case was thought to be of malignant GIST with very slow growth pattern because twenty one years had elapsed from the first therapy. This case followed a singular course. We report this case, together with some bibliographical comments.

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