Gastrointestinal stromal tumors(GISTs)are mesenchymal tumors that originate from the gastrointestinal tract,mostly from the stomach.GISTs are derived from the myenteric interstitial cells of Cajal and are caused by se...Gastrointestinal stromal tumors(GISTs)are mesenchymal tumors that originate from the gastrointestinal tract,mostly from the stomach.GISTs are derived from the myenteric interstitial cells of Cajal and are caused by several mutations in the c-kit and platelet-derived growth factor receptor genes.Clinically,GISTs are detected by endoscopic and imaging findings and are diagnosed by immunostaining.Surgery is the first line of treatment,and if the tumor is relatively small,minimally invasive surgery such as laparoscopy is performed.In recent years,neoadjuvant therapy has been administered to patients with GISTs that are suspected of having a large size or infiltration to other organs.Postoperative adjuvant imatinib is the standard therapy for high-risk GISTs.It is important to assess the risk of recurrence after GIST resection.However,the effect of tyrosine kinase inhibitor use will vary by the mutation of c-kit genes and the site of mutation.Furthermore,information regarding gene mutation is indispensable when considering the treatment policy for recurrent GISTs.This article reviews the clinicopathological characteristics of GISTs along with the minimally invasive and multidisciplinary treatment options available for these tumors.The future perspectives for diagnostic and treatment approaches for these tumors have also been discussed.展开更多
BACKGROUND A gastrointestinal stromal tumor(GIST)is a mesenchymal tumor of the gastrointestinal tract that is most commonly found in the stomach.Recurrence of GISTs mostly occurs in the liver or peritoneum,and in most...BACKGROUND A gastrointestinal stromal tumor(GIST)is a mesenchymal tumor of the gastrointestinal tract that is most commonly found in the stomach.Recurrence of GISTs mostly occurs in the liver or peritoneum,and in most cases,multiple metastases occur.As a solitary peritoneal metastasis is rare,an appropriate treatment strategy has not been established.Here,we report a case of solitary peritoneal metastasis after complete resection of gastric GIST.CASE SUMMARY A 76-year-old woman was diagnosed with stomach GIST and underwent laparoscopic local resection using the CLEAN-NET method.As the recurrence risk was intermediate,adjuvant imatinib therapy was not administered.Two years after surgery,routine computed tomography revealed an abdominal mass between the dorsal side of the right hepatic lobe and right kidney.Other imaging tests did not reveal any abnormalities.Laparoscopic observation showed that the tumor was located at the retroperitoneum,and intraperitoneal dissemination was not found.Therefore,we performed laparoscopic tumor resection.Immunohistochemically,the tumor was positive for c-kit and CD34 and had a relatively high mitotic index and MIB-1 Labeling index.We administered adjuvant imatinib therapy.There was no evidence of recurrence 3 years after the operation.CONCLUSION This is the first reported case of a solitary recurrence of GIST in the peritoneum treated with complete laparoscopic resection.展开更多
文摘Gastrointestinal stromal tumors(GISTs)are mesenchymal tumors that originate from the gastrointestinal tract,mostly from the stomach.GISTs are derived from the myenteric interstitial cells of Cajal and are caused by several mutations in the c-kit and platelet-derived growth factor receptor genes.Clinically,GISTs are detected by endoscopic and imaging findings and are diagnosed by immunostaining.Surgery is the first line of treatment,and if the tumor is relatively small,minimally invasive surgery such as laparoscopy is performed.In recent years,neoadjuvant therapy has been administered to patients with GISTs that are suspected of having a large size or infiltration to other organs.Postoperative adjuvant imatinib is the standard therapy for high-risk GISTs.It is important to assess the risk of recurrence after GIST resection.However,the effect of tyrosine kinase inhibitor use will vary by the mutation of c-kit genes and the site of mutation.Furthermore,information regarding gene mutation is indispensable when considering the treatment policy for recurrent GISTs.This article reviews the clinicopathological characteristics of GISTs along with the minimally invasive and multidisciplinary treatment options available for these tumors.The future perspectives for diagnostic and treatment approaches for these tumors have also been discussed.
文摘BACKGROUND A gastrointestinal stromal tumor(GIST)is a mesenchymal tumor of the gastrointestinal tract that is most commonly found in the stomach.Recurrence of GISTs mostly occurs in the liver or peritoneum,and in most cases,multiple metastases occur.As a solitary peritoneal metastasis is rare,an appropriate treatment strategy has not been established.Here,we report a case of solitary peritoneal metastasis after complete resection of gastric GIST.CASE SUMMARY A 76-year-old woman was diagnosed with stomach GIST and underwent laparoscopic local resection using the CLEAN-NET method.As the recurrence risk was intermediate,adjuvant imatinib therapy was not administered.Two years after surgery,routine computed tomography revealed an abdominal mass between the dorsal side of the right hepatic lobe and right kidney.Other imaging tests did not reveal any abnormalities.Laparoscopic observation showed that the tumor was located at the retroperitoneum,and intraperitoneal dissemination was not found.Therefore,we performed laparoscopic tumor resection.Immunohistochemically,the tumor was positive for c-kit and CD34 and had a relatively high mitotic index and MIB-1 Labeling index.We administered adjuvant imatinib therapy.There was no evidence of recurrence 3 years after the operation.CONCLUSION This is the first reported case of a solitary recurrence of GIST in the peritoneum treated with complete laparoscopic resection.
