title: Imatinib (STI-571) heals a gastrocutaneous fistula resulting from a malignant gastric stromal tumor.
abstract: The management of inoperable giant malignant gastrointestinal stromal tumor (GIST) of the stomach sed to be a formidable task. We report our success with the use of STI-571 in treating a patient with huge GIST of the stomach complicated by gastrocutaneous fistula after an unsuccessful laparotomy. The patient was a 49-year-old man who presented to our center with a painful epigastric mass in December 2001. Endoscopy, biopsy, and magnetic resonance scan confirmed that it was a malignant stromal tumor arising from the gastric fundus. Laparotomy with an intention to resect the tumor was performed in view of the obstructing symptoms. However, massive bleeding was encountered during dissection of the tumor and gastrectomy was abandoned. The case was further complicated with the development of a gastrocutaneous fistula in the early postoperative period. The patient ws then managed with naso-duodenal tube feeding and enteral STI-571 was prescribed. The fistula healed up in 20 days and the mass became impalpable 1 month afterwards. Follow-up computed tonography (CT) scan 3 months later confirmed significant tumor reduction, and the patient has experienced no side effects from the treatment
authors.affiliation: Department of Surgery, The Chinese University of Hong Kong, China.
authors.forename: Enders K W
authors.initials: EK
authors.lastname: Ng
authors.forename: Simon K H
authors.initials: SK
authors.lastname: Wong
authors.forename: Tony S K
authors.initials: TS
authors.lastname: Mok
authors.forename: W Y
authors.initials: WY
authors.lastname: Chan
authors.forename: S C Sydney
authors.initials: SC
authors.lastname: Chung
mesh_terms: D001549:Benzamides; D017577:Cutaneous Fistula / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D005747:Gastric Fistula / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D000068877:Imatinib Mesylate; D007813:Laparotomy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology; D011720:Pyrazoles / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: C108123:4-amino-5-(4-methylphenyl)-7-(tert-butyl)pyrazolo(3,4-d)pyrimidine; D001549:Benzamides; D010879:Piperazines; D011720:Pyrazoles; D011743:Pyrimidines; D000068877:Imatinib Mesylate