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A Simplified Operation for the Endovascular Perforation Murine Model of Subarachnoid Hemorrhage
Published on: June 13, 2025
[A Case Survived Long Period after Repeated Operation against the Small Intestinal GIST with Perforation]
Keisuke Koumori1, Takuo Watanabe, Ayano Kakazu
1Dept. of Surgery, Japanese Red Cross Hadano Hospital.
Abstract:
A patient was 60-year-old man. In March 2011, the small bowel tumor with perforation was found and the partial resection of small intestine was urgently performed. KIT of resected specimen was positive. Then, diagnosis as GIST was defined. Oral administration of imatinib was started, but it was finished in 5 months because of development of the systemic edema. In February 2013, the abdominal CT revealed a tumor of 20 cm in size in the pelvis. Upon laparotomy, we detected the GIST recurrence generated at the region of small intestine anastomosis where manipulated previously, then resected all of tumor and partially small intestine. Afterward, we diagnosed as a recurrence of GIST. In March 2014, the abdominal CT found 4 cm sized mesenteric tumor and 2 cm sized abdominal wall tumor. The laparotomy was performed and we found 5 disseminated nodules intraperitoneally. We confirmed that all of these disseminated nodules were successfully removed. We defined them as re-recurrence of GIST. Six years and 5 months have elapsed since the first operation was performed, but there is no sign of three times recurrence.
Insights
A 60-year-old man with gastrointestinal stromal tumor (GIST) experienced multiple recurrences. Despite initial treatment and recurrence, the patient achieved long-term remission without further signs of disease.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Medical Oncology
Background:
- Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract.
- KIT-positive GIST necessitates tailored treatment strategies, including surgical resection and targeted therapy.
Observation:
- A 60-year-old male patient presented with a perforated small bowel tumor, diagnosed as KIT-positive GIST.
- The patient underwent initial surgery, followed by imatinib therapy, which was discontinued due to systemic edema.
- Recurrence was observed in the pelvis (20 cm tumor) in 2013, followed by mesenteric and abdominal wall tumors in 2014, with successful resection of all disseminated nodules.
Findings:
- Complete resection of primary GIST and subsequent recurrences was achieved.
- The patient remained disease-free for over six years following the initial diagnosis and multiple surgical interventions.
- Successful management of recurrent GIST through aggressive surgical intervention is demonstrated.
Implications:
- Aggressive surgical management can lead to long-term remission in patients with recurrent GIST.
- Multidisciplinary approaches are crucial for optimizing outcomes in complex GIST cases.
- This case highlights the potential for successful outcomes even with multiple GIST recurrences and treatment challenges.
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