title: Liver transplantation for metastasized extragastrointestinal stromal tumor: a case report and an overview of literature.
abstract: A 63-year-old woman underwent living donor liver transplantation for hepatic metastases of an extragastrointestinal stromal tumor (EGIST) originating from the rectovaginal space. Due to a multifocal extrahepatic tumor recurrence, treatment with imatinib mesylate was started after extensive pharmacokinetic studies to rule out possible interactions with immunosuppressives. We performed several re- resections for EGIST recurrence thereafter. At the last follow-up, 17 years after primary tumor resection and 10 years after living donor liver transplantation, the patient is symptom-free under immunosuppressive and imatinib mesylate treatments with a 2-cm stable recurrent pararectal EGIST. To our knowledge, this is the only report published on a patient who underwent transplantation for hepatic EGIST metastases with a posttransplantation follow-up of 10 years and the first report on living donor liver transplantation for metastasized EGIST. This is the first description of pharmacokinetics of imatinib and its main active metabolite CGP74588 in a liver transplant recipient.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, United Kingdom. a.frilling@imperial.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Frilling
authors.forename: M
authors.initials: M
authors.lastname: Malago
authors.forename: G
authors.initials: G
authors.lastname: Testa
authors.forename: E
authors.initials: E
authors.lastname: Schleyer
authors.forename: F
authors.initials: F
authors.lastname: Grabellus
authors.forename: R
authors.initials: R
authors.lastname: Kronenberger
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: C E
authors.initials: CE
authors.lastname: Broelsch
mesh_terms: D000970:Antineoplastic Agents / Q000493:pharmacokinetics; D001549:Benzamides; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology*; D006801:Humans; D000068877:Imatinib Mesylate; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010879:Piperazines / Q000493:pharmacokinetics; D011743:Pyrimidines / Q000493:pharmacokinetics; D012004:Rectal Neoplasms / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome; D014625:Vaginal Neoplasms / Q000473:pathology*
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; C464561:CGP 74588; D007166:Immunosuppressive Agents; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate