A Case of Duodenal Gastrointestinal Stromal Tumor with Resected Local Recurrence 9 Years after Surgery

Abstract

The patient was a 77-year-old man who underwent wedge resection of a gastrointestinal stromal tumor of the third portion of the duodenum in 2005. There was no recurrence, and follow-up observation was completed in 2011. He was found to have anemia and was referred to our hospital in 2014. Examination showed a tumor in the third portion of the duodenum. Partial duodenectomy was performed due to suspected local recurrence. Because histopathological examination showed a tissue image similar to that at the initial surgery, and it occurred near the previously resected area, local recurrence of the duodenal GIST was diagnosed. A review of the Japanese reports on duodenal GIST that caused late recurrence showed that, in cases with a low mitotic index and a large tumor size, there is a possibility of late recurrence, and long-term follow-up may be necessary. In principle, the treatment of recurrent GIST is imatinib, but there are cases in which the prognosis is expected to improve with resection, as in the present case. It is necessary to clarify the clinical picture of such cases to be able to select appropriate therapy in the future.