Curative Resection of a Duodenal Gastrointestinal Stromal Tumor following Preoperative Downsizing Chemotherapy with Imatinib—A Case Report—

Abstract

A 46-year-old woman presented with upper abdominal pain and was diagnosed with a large (150 mm) tumor in the hepatic hilar region by computed tomography (CT). Further investigations confirmed the presence of a duodenal gastrointestinal stromal tumor (GIST). Due to the tumor's unresectable nature, the patient was administered imatinib as part of a downsizing chemotherapy strategy. Remarkably, the tumor showed a marked reduction in size after imatinib treatment, and 24 months later, the patient underwent a radical pancreaticoduodenectomy with complete R0 resection. The patient remains alive 54 months after the surgery. The findings in this case demonstrate that downsizing chemotherapy with imatinib can be an effective treatment strategy to improve the R0 resection rate for unresectable duodenal GIST, with radical surgical resection remaining the primary treatment modality for GIST.