A CASE OF RECURRENT GIST OF THE SMALL INTESTINE FOR WHICH A TYROSINE KINASE INHIBITOR STI571 WAS EFFECTIVE

Abstract

A 69-year-old man who had undergone operation for malignant GIST of the small intestine and liver metastasis developed liver metastasis that was repeatedly treated with hepatic resection, percutaneous microwave coagulation therapy (PMCT) and transarterial embolization (TAE). A recurrent tumor in the abdominal wall, intra-abdominal metastasis and multiple liver metastasis were found. A needle biopsy specimen obtained from the recurrent abdominal tumor was histologically evaluated and gastrointestinal stromal tumor was diagnosed. The diagnosis was confirmed by immunostaining for c-kit and CD34. Gene analysis revealed that the GIST has mutation in exonll. The patient was treated with 400mg of STI571 once daily. On an abdominal CT scan and ultrasonography conducted about 2 months after treatment, the metastatic tumors became smaller and a histological study of needle biopsy specimens obtained from the abdominal wall tumor revealed no tumor cells in the abdominal wall. We experienced the case of inoperable recurrent malignant GIST for which STI571 was effective.