A 53-year-old man was referred to our hospital because of abdominal fullness. Abdominal CT revealed a huge gastric tumor, invading spleen, liver and pancreas. Gastroscopy showed submucosal tumor (SMT) . It was diagnosed GIST by staining positively for c-kit. Administration of imatinib was begun as neoadjuvant chemotherapy during three-month period. As a result we estimated partial response (PR) in accordance with RECIST guideline. After that we underwent total gastrectomy with splenectomy and partial pancreatectomy as a total excision of the huge tumor. A few viable cells were observed in the tumor. He was doing well after surgery. We decided not to give the adjuvant dosage
after consultation with him. There is no sign of recurrence for ten months after operation. Imatinib as neoadjuvant chemotherapy was effective for huge GIST on this case. We hope to build up further prospective study.
