2021 Volume 54 Issue 11 Pages 776-787
We herein report three surgically resected cases of esophageal gastrointestinal stromal tumor (GIST) using different treatment strategies. The first case was a 51-year-old man diagnosed with a small low-risk GIST, who underwent thoracoscopic enucleation of the tumor. The second case was a 77-year-old woman with a large GIST located in the lower esophagus, for which esophagectomy with reconstruction via a thoracoabdominal approach was initially required. After preoperative treatment with imatinib, transhiatal lower esophagectomy and proximal gastrectomy were successfully performed. The third case was an 84-year-old woman with a submucosal tumor at the esophagogastric junction, for which definitive diagnosis of GIST was not possible before surgery. Because the tumor increased in size, it was clinically suspected to be GIST and transhiatal lower esophagectomy and proximal gastrectomy were performed. Enucleation for a small low-risk esophageal GIST (case 1) and preoperative treatment with imatinib for a large esophageal GIST (case 2) can avoid invasive esophagectomy and reconstruction. A therapeutic strategy avoiding thoracic esophagectomy should be selected for treatment of esophageal GIST, based on the balance between surgical invasiveness and curability.
