Perineal Approach for a Gastrointestinal Stromal Tumor of the Lower Rectum—A Case Report—

Abstract

A 56-year-old man presented with perineal discomfort and was found to have an anal tumor. He was diagnosed with a gastrointestinal stromal tumor (GIST) based on the biopsy specimens. Computed tomography (CT) and magnetic resonance imaging (MRI) showed an extramural tumor approximately 6 cm in diameter in the anterior wall of the lower rectum (Rb-P) displacing the urethra ventrally. Imatinib mesylate as neoadjuvant chemotherapy was administered to reduce tumor size, and radical surgery was planned six months later. The tumor was resected by the perineal approach because the tumor was located close enough to the perineum to be palpable through the perineal skin. The patient's postoperative course was uneventful, and the patient was discharged 13 days after the operation. This perineal approach for GIST is one option for minimally invasive surgery instead of invasive surgery requiring intersphincteric resection and abdominoperineal resection. We expect that a future study will provide further evaluation of the perineal approach for lower rectal tumors.