A resected case of giant duodenal gastrointestinal stromal tumor with a liver metastasis that responded to imatinib neoadjuvant therapy

Abstract

A 59-year-old male had a giant mass located in the upper right abdomen. On abdominal CT large lesion with a largest diameter of 20 cm was detected, ; a lesion with a diameter of 20 mm and a marginal contrast effect was also detected in the hepatic posterior segment. On upper gastrointestinal endoscopy, a submucosal neoplastic lesion was detected in the descending part of the duodenum ; forceps biopsy specimens were found to be c-kit-positive and CD34-positive on immunostaining. A gastrointestinal stromal tumor was diagnosed. Imatinib mesylate (400 mg per day) was administered for 309 days. A cytoreductive effect was obtained, and therefore a pancreaticoduodenectomy, a right hemicolectomy, and a partial hepatectomy could be done. Imatinib was not given after surgery. Currently, 15 months after surgery, the patient is relapse-free.