Abstract
A 74-year-old woman was admitted to the hospital because of body weight loss of 4kg in June 2002. A 10cm sized abdominal mass was palpable and was visualized as a heterogeneous image by abdominal ultrasonography. Abdominal CT scan indicated a left abdominal mass enhanced heterogeneously. Angiography showed a hyper vascular tumor fed by jejunal arteries. On the 14th hospital day, she went into shock by massive anal bleeding, and upper jejunal resection with left hemicolectomy was performed. The resected specimen showed a tumor 12cm in diameter in the mesojejunum that invaded the jejunum and descending colon. The part of jejunal invasion caused intestinal bleeding. Histo-and immuno-pathological findings indicated gastrointestinal stromal tumor (GIST) arisen in the mesentery of the jejunum. In June 2003, CT scan revealed multiple liver tumors which were 70mm in the maximum diameter. She was diagnosed as having recurrence of GIST and started administration of imatinib mesilate. In September 2003, CT scan showed reduced tumors and fluid level in the tumors. In September 2004, these liver tumors showed cystic change and reduced to 35mm in the maximum diameter. In April 2005, CT scan showed two liver tumors enhanced positively which were diagnosed as re-recurrence, and TAE was performed. Following TAE, CT scan revealed excellent stain of lipiodol. She is living without further recurrence.
