2017 Volume 50 Issue 5 Pages 350-356
A 73-year-old man had a chief complaint of anorexia and we diagnosed a huge gastric GIST with peritoneal dissemination. Imatinib mesylate (imatinib) (400 mg/day) was given orally and CT revealed a reduction in tumor diameter of 45% a month after start of imatinib therapy. However continuation of imatinib therapy was difficult because of repeated adverse events such as febrile neutropenia and anorexia. He was diagnosed with the abscess formation in the tumor because of the fistulation between the gastric lumen and the tumor by CT and underwent surgery to control infection. The gastric GIST adhered to the transverse colon and the pancreas so he underwent proximal gastrectomy, partial resection of transverse colon, distal pancreatectomy and splenectomy. Peritoneal dissemination was also resected as much as possible. Microscopic findings of resected specimen revealed that there was no viable GIST cells. Forty-five days after the surgery, imatinib (400 mg/day) was resumed and he has been in good health without a recurrence for 18 months after the surgery.
