Abstract
A 59-year-old man presented with abdominal fullness and constipation in January 2003. Abdominal dynamic CT and MRI revealed a huge solid tumor, 40 × 19 cm in diameter, occupying the whole abdomen and the pelvic cavity. GIST was suspected on clinical images and confirmed by percutaneous needle biopsy. At laparotomy, the tumor was located in the left abdomen involving the stomach. The tumor was completely excised by proximal gastrectomy with combined resection of the distal pancreas, spleen, left adrenal gland and the left diaphragm. The resected specimen was 40 × 27 × 20 cm in size, weighing 4860 g. Hepatic metastasis occurred one year after the operation, and tumor extirpation was performed. He received imatinib chemotherapy after the second operation and has lived well for three years without apparent recurrence. The patients with GIST are associated with nonspecific symptoms, and often asymptomatic until the tumor becomes large. We present a case of huge GIST and discuss the management of advanced and metastatic GIST.
