2017 Volume 31 Issue 7 Pages 916-920
Background: Diaphragmatic metastasis of gastrointestinal stromal tumor (GIST) is rarely treated surgically. Resection of diaphragmatic metastases of GIST has thus not been studied in depth. We report a case of diaphragmatic metastases of GIST.
Case Report: A 64-year-old woman with a bulky intraperitoneal tumor was diagnosed with GIST by open abdominal biopsy. Two years and eight months after completing chemotherapy with imatinib and sunitinib, she underwent resection of the primary tumor in the duodenum and nearby organs (tail of the pancreas, spleen, left adrenal gland, small intestine, and transverse colon). As she declined postoperative chemotherapy, she took no medication. Three years and three months later, a right diaphragmatic tumor suspected to be GIST metastasis was identified at the right lower lobe of the lung or right diaphragm, and tumor resection was performed. The postoperative pathological diagnosis was diaphragmatic metastases of GIST. The mechanism of recurrence in this case was considered to be hematogenous metastasis to the right diaphragm or diaphragm penetration by peritoneal dissemination.
Conclusion: Surgery is not indicted for lung metastases of GIST because of the lack of clinical evidence for a sufficiently improved prognosis. However, surgical treatment in carefully selected cases of diaphragmatic metastasis of GIST might improve the prognosis.
