title: [A resected case of postoperative liver metastasis of a gastrointestinal stromal tumor showing complete response after imatinib treatment].
abstract: A 71-year-old man visited the hospital complaining of nausea in December 2002. Following a diagnosis of a gastrointestinal stromal tumor (GIST), partial resection of the stomach was performed in January 2003. The tumor was immunohistochemically positive for c-kit and CD34. The tumor size was 6.5 x 5.0 x 4.5 cm with a mitotic index of 25 out of 50 in the high-power field. The pathological diagnosis indicated a high-risk GIST. Treatment with imatinib at a dose of 400 mg/day was started because of liver metastasis of the GIST in January 2004. The liver metastasis was gradually reduced and exhibited cystic change. We considered that there was a complete response without accumulation by FDG-PET in June 2007. An hepatic segmentectomy was performed and imatinib was discontinued in July 2007. Most intratumorale in the specimen underwent hyaline degeneration after pathological examination, but there were viable cells in a portion of the tumor border. Imatinib treatment was resumed because of recurrence in the remnant stomach four months postoperatively owing to imatinib withdrawal. In making a diagnosis at the cell level by FDG-PET, it was difficult to determine the effectiveness of imatinib, and therefore, it is suggested that imatinib treatment must be continued after surgical resection.
authors.affiliation: Division of Gastroenterology, Dept. of Surgery, Kawasaki Medical School.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yamamura
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Hirai
authors.forename: Masaharu
authors.initials: M
authors.lastname: Higashida
authors.forename: Hisako
authors.initials: H
authors.lastname: Kubota
authors.forename: Haruaki
authors.initials: H
authors.lastname: Murakami
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kawabe
authors.forename: Masaharu
authors.initials: M
authors.lastname: Ikeda
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hirabayashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Okawaki
authors.forename: Katsuji
authors.initials: K
authors.lastname: Hironaka
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Oka
authors.forename: Hideo
authors.initials: H
authors.lastname: Okumura
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiyama
authors.forename: Hideo
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Urakami
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yamashita
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yamaguchi
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Tsunoda
mesh_terms: D000368:Aged; D001549:Benzamides; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D000068877:Imatinib Mesylate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D008297:Male; D010879:Piperazines / Q000627:therapeutic use*; D049268:Positron-Emission Tomography; D011743:Pyrimidines / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate