Abstract
A case of esophageal gastrointestinal tumor (GIST) of 12 cm in largest dimension resected by laparoscopic surgery is reported. The patient was a 69-year-old man who was referred to our hospital because of an abnormal shadow on chest X-ray. Computed tomography showed a giant solid tumor, which was 10×10 cm2 and enhanced heterogeneously, adjacent to the left side of the thoracic cavity. T1-weighted MRI showed mild hyperintensity, suggesting bleeding in the tumor. Under endoscopic guidance, the tumor was diagnosed by fine-needle aspiration biopsy as an esophageal GIST that was c-kit positive on immunohistochemistry. Laparoscopic surgery was performed via the left diaphragm. After lower esophagectomy, intrathoracic esophagogastrostomy by double-flap technique was performed laparoscopically. Pathological findings showed c-kit positive, mitoses 62/50 HPF, and high-risk GIST by Fletcher's classification. The patient has been doing well after surgery, and adjuvant chemotherapy with imatinib was started.
