Adjuvant therapy for rare rectal gastrointestinal stromal tumors: A case report

• Published in: Clinical case reports Vol. 12; no. 4; pp. e8774 - n/a
• Main Authors: Chu, Ting‐Yi, Pu, Ta‐Wei, Chen, Chao‐Yang
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.04.2024; John Wiley and Sons Inc; Wiley
• Subjects: Case Report; Case reports; Colonoscopy; Colorectal cancer; Gastrointestinal cancer; gastrointestinal stromal tumors; imatinib mesylate; Kinases; Magnetic resonance imaging; Medical prognosis; Mutation; Patients; rectal neoplasms; Rectum; recurrence; Surgery; Tumors; tyrosine kinase inhibitors; recurrence; tyrosine kinase inhibitors; rectal neoplasms; gastrointestinal stromal tumors; imatinib mesylate
• ISSN: 2050-0904; 2050-0904
• DOI: 10.1002/ccr3.8774

Key Clinical Message Anorectal gastrointestinal stromal tumors are extremely rare, constituting less than 0.1% of rectal tumors. Surgical resection using a transanal wide excision followed by adjuvant therapy with tyrosine kinase inhibitors can be a successful treatment combination to remove the mass and prevent recurrence while preserving the integrity of the anal sphincter. Gastrointestinal stromal tumors (GISTs) are a rare subset of neoplasms, accounting for about 1%–2% of primary gastrointestinal malignancies. The stomach is the most common site for GISTs, with anorectal GISTs being exceptionally rare, representing only 0.1% of all rectal tumors. The standard approach for managing localized GIST involves complete surgical excision to achieve negative microscopic margins (R0) while preserving the tumor capsule and maintaining anal sphincter function. Surgical resection with transanal wide excision followed by adjuvant therapy using tyrosine kinase inhibitors can successfully remove the mass, prevent recurrence, and preserve the anal sphincter's integrity. Adjuvant therapy with imatinib is the recommended treatment for all localized GISTs assessed to have an intermediate or high risk of relapse. Here, we report a case of a 63‐year‐old male with a rectal GIST who underwent transanal wide excision followed by adjuvant therapy with tyrosine kinase inhibitors.