title: Transanal endoscopic microsurgery following treatment with imatinib : a case report of a patient with a rectal gastrointestinal stromal tumor.
abstract: BACKGROUND
  Gastrointestinal stromal tumors (GIST) of the rectum are a challenge for the colorectal surgeon. In case of a locally advanced rectal GIST, an extended or multivisceral resection with significant morbidity and -mortality is often necessary. Literature is lacking on the combined modality of transanal endoscopisc microsurgery (TEM) following imatinib for these patients.
  
  
  METHODS
  We describe a combined approach for a locally advanced GIST of the rectum with preoperative imatinib -treatment and subsequent local excision using the TEM procedure.
  
  
  RESULTS
  After six months of treatment with imatinib the TEM procedure was successfully performed with a radical -resection of the remnant tumor. Twenty-four months after surgery this patient has no evidence of disease.
  
  
  CONCLUSIONS
  A TEM procedure following treatment with imatinib may safely be performed in selected patients with a locally advanced GIST.
authors.affiliation: Department of Surgical Oncology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Tielen
authors.forename: A J A
authors.initials: AJ
authors.lastname: Bremers
authors.forename: W T A
authors.initials: WT
authors.lastname: van der Graaf
authors.forename: U E
authors.initials: UE
authors.lastname: Flucke
authors.forename: J H W
authors.initials: JH
authors.lastname: de Wilt
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001549:Benzamides / Q000627:therapeutic use*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000628:therapy*; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D020360:Neoadjuvant Therapy; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate