2016 Volume 52 Issue 5 Pages 1067-1072
A 9-year-old girl was placed under 5-month follow-up observation for anemia before visiting our hospital. She complained of abdominal pain and malaise, and significant anemia was observed in blood tests. Thus, she was referred to our hospital for inpatient examination and treatment. A submucosal tumor of the posterior wall of the gastric angle [gastrointestinal stromal tumor (GIST)] was suspected on the basis of the results of detailed examinations. Local resection of the stomach by laparoscopic and endoscopic cooperative surgery (LECS) was attempted on hospital day 24.However, intraoperative endoscopic findings showed an ulcer remaining at the top of the tumor. Therefore, local resection of the stomach was implemented to prevent the peritoneal dissemination of the tumor. The postoperative course was favorable, and she was discharged on postoperative day 9. High-risk gastric GIST was diagnosed on the basis of histopathological and genetic tests, but no genetic mutations were observed using a c-kit (exons 9, 11, 13, 17), PDGFRA (exons 12, 14, 18), or BRAF (exon 15), and SDHB immunostaining also yielded negative results. Postoperative adjuvant chemotherapy was therefore not administered. No recurrences have been identified 25 months after surgery.
