[A case of rapid growth GIST successfully treated with resection after long-term use of imatinib]

We report a case of rapid growth GIST successfully treated with resection, which imatinib controlled it as a stable disease for three years. A 68-year-old woman underwent simple hysterectomy and bilateral oophorectomy for the pelvic tumor. In the operation, there were multiple disseminations in the greater omentum and peritoneum. After diagnosed as high risk GIST, the patient was treated with imatinib at a dose of 400 mg/day, and the tumor was controlled as a stable disease for 3 years. At the end of 2008, lower abdominal tumor grew rapidly and intra-abdominal hemorrhage appeared. Although sunitinib was administered at a dose of 37.5 mg/day, the tumor was enlarged, and sunitinib was stopped because the patient developed grade 3 diarrhea. IVR was tried to control abdominal hemorrhage, but it was unsuccessful. The patient's general condition was getting worse, ECOG performance status 3. In January 2009, the resection of main tumor was performed to control abdominal hemorrhage. After the operation, a general condition of the patient was getting better, ECOG performance status 1. The resection for drug resistant GIST may contribute to improve the patient's quality of life.