title: Neoadjuvant imatinib treatment and laparoscopic anus-preserving surgery for a large gastrointestinal stromal tumor of the rectum.
abstract: BACKGROUND
  Resection of a gastrointestinal stromal tumor (GIST) of the rectum can be difficult because of the particular location in the pelvis, and a large rectal GIST often requires abdominoperineal resection. Recent reports demonstrate that neoadjuvant imatinib treatment improves surgical outcomes in patients with a rectal GIST, and there are only a few reports of the effectiveness of laparoscopic surgery for a rectal GIST.
  
  
  METHODS
  A 46-year-old man was found to have a rectal GIST that measured 80 mm and was located on the anterior wall of the lower rectum. After 6 months treatment with imatinib, the tumor decreased in size to 37 mm, and laparoscopic low anterior resection was performed. The patient is currently alive without any evidence of recurrence 37 months after surgery.
  
  
  CONCLUSIONS
  Neoadjuvant imatinib should be a treatment of choice for a large rectal GIST. When marked tumor shrinkage is achieved, laparoscopic surgery may be the preferred procedure.
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. kkyo@vega.ocn.ne.jp.
authors.forename: Kennoki
authors.initials: K
authors.lastname: Kyo
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. m-azuma@tc4.so-net.ne.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Azuma
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. okapon.surg@gmail.com.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. moto1vasc@gmail.com.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Nishiyama
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. shimamura@hospital.fujieda.shizuoka.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Shimamura
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. maema@yacht.ocn.ne.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Maema
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. hkanamaru@hospital.fujieda.shizuoka.jp.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kanamaru
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. m-shirakawa@mue.biglobe.ne.jp.
authors.forename: Motoaki
authors.initials: M
authors.lastname: Shirakawa
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. nakamurat@hospital.fujieda.shizuoka.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Pathology, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan. kzshinmu@hama-med.ac.jp.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Shinmura
authors.affiliation: Department of Pathology, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. path@hospital.fujieda.shizuoka.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Koda
authors.affiliation: Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka, 426-8677, Japan. hiyokoyama@hospital.fujieda.shizuoka.jp.
authors.forename: Hidetaro
authors.initials: H
authors.lastname: Yokoyama
mesh_terms: D001003:Anal Canal; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000628:therapy*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000628:therapy*; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D059351:Organ Sparing Treatments; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D000068877:Imatinib Mesylate