Abstract
We report a case of multiple hepatic metastases of gastric gastrointestinal stromal tumor (GIST) successfully treated with total gastrectomy and imatinib mesylate, A 75-year old man was admitted to our hospital due to hematemesis. An emergency upper endoscopy disclosed submucosal tumor (SMT) and bleeding ulcer. Abdominal CT showed a mass 12cm in diameter occupying left upper abdominal cavity and multiple liver tumor. The patient underwent total gastrectomy. Immunohistochemical examination of gastric SMT was positive for KIT and CD34, and negative for S100 and SMA, and a diagnosis of gastric GIST with multiple liver metastases was made. Treatment with imatinib mesylate at a dose of 400mg/day was started. Two months after treatment, FDG-PET imaging revealed decrease of FDG uptake in the liver metastases. The combination of resection of primary lesion and administration of imatinib mesylate was an effective treatment for the patient with gastric GIST with multiple liver metastases.
