A case of gastrointestinal stromal tumor of the jejunum successfully treated by preoperative induction chemotherapy with imatinib mesylate administered through jejunostomy and subsequent surgical resection

• Published in: Gan to kagaku ryoho Vol. 41; no. 3; p. 391
• Main Authors: Kimura, Hideyo, Ohtsuka, Takao, Toma, Hiroki, Ueda, Junji, Mizuuchi, Yusuke, Yamamoto, Hidetaka, Takahata, Shunichi, Oda, Yoshinao, Ueki, Takashi, Tanaka, Masao
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.03.2014
• Subjects: Aged; Antineoplastic Agents - therapeutic use; Benzamides - therapeutic use; Chemotherapy, Adjuvant; Female; Gastrointestinal Stromal Tumors - drug therapy; Gastrointestinal Stromal Tumors - surgery; Humans; Imatinib Mesylate; Jejunal Neoplasms - drug therapy; Jejunal Neoplasms - pathology; Jejunal Neoplasms - surgery; Jejunostomy; Piperazines - therapeutic use; Pyrimidines - therapeutic use
• ISSN: 0385-0684

A 70 -year-old female patient with a palpable mass in the left upper abdomen suffered from abdominal pain and fever. Abdominal computed tomography showed a jejunal tumor 11 cm in diameter with ascites, suggesting rupture of the tumor. Histological diagnosis via endoscopic ultrasound-guided fine needle aspiration indicated c-kit-positive gastrointestinal stromal tumor. Diagnostic laparoscopy demonstrated a large jejunal tumor possibly invading the stomach and pancreas. The patient then underwent tube jejunostomy. Thereafter, preoperative induction chemotherapy with imatinib mesylate(400mg/ body/day)via jejunostomy was administered for 6 months, resulting in 20%reduction of the tumor diameter and disappearance of any indication of stomach and pancreas invasion. The patient then underwent radical partial resection of the jejunum without combined resection of either the stomach or pancreas. Postoperative adjuvant chemotherapy with imatinib mesylate (400mg/body/day)was also indicated. No sign of recurrence has been detected to date after 1 year of follow-up.