Abstract
A 40-year-old woman visited our hospital because of bouts of tarry stool in April 1996. Blood examination showed marked anemia (Hb5.3g/dl). Bleeding scintigraphy showed extravasation of RI in the right lower abdomen, and technetium scintigraphy showed focal uptake on the right side in the pelvis. A bleeding Meckel's diverticulum was suspected, and an emergent operation was performed. At laparotomy, no Meckel's diverticulum was found but a tumor 7cm in diameter was found about 160cm oral side from the ileocecal valve. A partial resection of the small intestine was performed. Immunohistochemically, the tumor cells were positive for c-kit, and the diagnosis of GIST was confirmed. Liver metastases were observed 3 times in the next 7 years and the recurrent tumors were surgically removed. We started chemotherapy with imatinib mesylate at a dose of 200 mg/day for two years in August 2003. She had been free from relapse during undergoing the chemotherapy. Eleven months after withdrawal of the chemotherapy, metastasis to the liver remnant occurred again, and then forth hepatectomy was peformed. The patient is now alive and well, as of 10 years after the initial operation.
