Massive intraperitoneal stromal tumour: two-year follow-up.
BACKGROUND
Gastrointestinal stromal tumours (GISTs) are rare. Few cases of such tumours are reported in the literature. Until recently, they were only treated surgically but, nowadays, for high grade tumours, we can consider wide excision, not only as a palliative measure, but also to enable subsequent treatment with Imatinib mesylate.


METHODS
We describe the case of a patient with a high-grade GIST, who, two years after undergoing surgery and medical treatment, is still in remission. Computerised axial tomography (CT) of the abdomen detected the presence of multiple heterogeneous solid masses of various sizes but no localised retroperitoneal adenopathies.


RESULTS
Median laparotomy was performed and revealed multiple intraperitoneal tumours. The larger masses were excised and the smaller residual implants are currently being treated with Imatinib mesylate. The patient had visceral, parietal and peritoneal dissemination. One of them, located in the supramesocolic area, had a maximal diameter of 20cm. Another one, at the level of the retro-gastric space, had a diameter of 22cm. The other tumours were smaller and spread over the parietal and visceral peritoneum, mainly between the loops of the small intestine and pelvis. Two years after cytoreduction surgery, the patient is well and free of obvious disease and has shown a good tolerance to pharmacological treatment.


CONCLUSIONS
Imatinib mesylate has revolutionised the treatment of GIST and offers good palliation and prolongation of overall survival.
Déjardin
D del Castillo
Ddel C
Sant Joan University Hospital, Reus, Tarragona, Spain. ddelcastillo@grupsagessa.com
Carbajo-Ferré
E M
EM
González
M Hernández
MH
Pereferrer
F Sabench
FS
Blasco
S Blanco
SB
Pérez
J Sánchez
JS
Marín
A Sánchez
AS
Calvet
J Doménech
JD
Lara
C Díaz
CD
Lanao
M A Martinez
MA
Moreno
V Valentí
VV
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides; D014408:Biomarkers, Tumor / Q000097:blood; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D000068877:Imatinib Mesylate; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D010879:Piperazines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D001549:Benzamides; D014408:Biomarkers, Tumor; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate