Decreasing the burden: An unusual GIST presentation, a case report

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Gastrointestinal stromal tumors (GIST) are common mesenchymal neoplasms of the alimentary canal, often presenting with mass effects.
• Recurrence is frequent in GIST, and tumors can develop resistance to tyrosine kinase inhibitors (TKIs).
• Surgical resection is considered for improved outcomes in recurrent or refractory GIST.

Observation:

• A 52-year-old male with recurrent GIST, refractory to Imatinib and Sunitinib, presented with severe metastatic disease and bowel obstruction.
• Imaging revealed extensive carcinomatosis and dilated small bowel loops.
• Despite conservative management, the patient's condition worsened, necessitating surgical intervention.

Findings:

• Surgical debulking was performed to reduce tumor burden and alleviate obstructive symptoms.
• Post-operatively, the patient received Regorafenib therapy.
• This combined approach aimed to improve quality of life in a patient with advanced, refractory GIST.

Implications:

• Surgical debulking is crucial for managing extensive GIST, particularly when tumors are refractory to pharmacological treatments.
• Reducing tumor burden can enhance the efficacy of subsequent therapies.
• This strategy significantly improves the quality of life for patients with advanced gastrointestinal stromal tumors.