A Case of Liver Metastasis of Gastrointestinal Stromal Tumor That Was Resected after Treatment with Imatinib Mesylate and Sunitinib

  • Jung, Gum-O (Department of Surgery, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Chae, Kwon-Mook (Department of Surgery, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Park, Dong-Eun (Department of Surgery, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Shim, Hyeok (Department of Hemato-Oncology, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Park, Sang-Hyun (Department of Radiology, Wonkwang University Hospital, Wonkwang University College of Medicine) ;
  • Yun, Ki-Jung (Department of Pathology, Wonkwang University Hospital, Wonkwang University College of Medicine)
  • Published : 2010.12.31

Abstract

A 65-year old man underwent wedge resection for a gastrointestinal stromal tumor (GIST) of the gastric fundus in 1997. In 2003, the abdominal CT and sono-guided biopsy revealed he had a large GIST liver metastasis. He underwent treatment with 400 mg/day of imatinib mesylate. As a result, the liver metastasis markedly decreased in size. However, focal progression of the liver metastasis was observed on the follow up CT, so we increased the imatinib from 400 mg/day to 800 mg/day. We then performed extended left hepatectomy. We report here on a patient who presented with an isolated metastatic GIST to the liver, and the patient was successfully treated with imatinib therapy and hemihepatectomy.

Keywords

References

  1. Blanke CD, Demetri GD, von Mehren M, et al. Long-term results from a randomized phase II trial of standard- versus higher-dose imatinib mesylate for patients with unresectable or metastatic gastrointestinal stromal tumors expressing KIT. J Clin Oncol 2008;26:620-625. https://doi.org/10.1200/JCO.2007.13.4403
  2. Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 1998;279:577-580. https://doi.org/10.1126/science.279.5350.577
  3. Heinrich MC, Griffith DJ, Druker BJ, et al. Inhibition of c-kit receptor tyrosine kinase activity by STI 571, a selective tyrosine kinase inhibitor. Blood 2000;96:925-932.
  4. Miettinen M, Lasota J. Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med 2006;130:1466-1478.
  5. DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg 2000;231:51-58. https://doi.org/10.1097/00000658-200001000-00008
  6. Rankin C, von Mehren M, Blanke C, et al. Dose effect of imatinib (IM) in patients (pts) with metastatic GIST - a phase III sarcoma group study S0033. Proc Am Soc Clin Oncol 2004;Abstract 9005.
  7. Haller F, Detken S, Schulten HJ, et al. Surgical management after neoadjuvant imatinib therapy in gastrointestinal stromal tumours (GISTs) with respect to imatinib resistance caused by secondary KIT mutations. Ann Surg Oncol 2007;14: 526-532. https://doi.org/10.1245/s10434-006-9228-0
  8. Sym SJ, Ryu MH, Lee JL, et al. Surgical intervention following imatinib treatment in patients with advanced gastrointestinal stromal tumors (GISTs). J Surg Oncol 2008;98:27-33. https://doi.org/10.1002/jso.21065
  9. Bonvalot S, Eldweny H, Pechoux CL, et al. Impact of surgery on advanced gastrointestinal stromal tumors (GIST) in the imatinib era. Ann Surg Oncol 2006;13:1596-1603. https://doi.org/10.1245/s10434-006-9047-3
  10. DeMatteo RP, Maki RG, Singer S, Gonen M, Brennan MF, Antonescu CR. Results of tyrosine kinase inhibitor therapy followed by surgical resection for metastatic gastrointestinal stromal tumor. Ann Surg 2007;245:347-352. https://doi.org/10.1097/01.sla.0000236630.93587.59