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[A Case of Rectal GIST Resected using the TAMIS Method]
Shinya Yamashita1, Hidekazu Takahashi, Kazuko Matsushita
1Dept. of Gastroenterological Surgery, Nippon Life Hospital.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|March 17, 2022
Summary
Transanal minimally invasive surgery (TAMIS) successfully treated a low-grade rectal gastrointestinal stromal tumor (GIST). Post-operative imatinib therapy ensured no recurrence after two years, preserving anal function.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Oncology
Background:
- Rectal gastrointestinal stromal tumors (GIST) are rare neoplasms.
- Surgical management is the primary treatment for GIST.
- Transanal minimally invasive surgery (TAMIS) offers a less invasive approach for rectal tumors.
Observation:
- A 46-year-old woman presented with both uterine cancer and a lower rectal GIST.
- The patient opted for anal preservation, necessitating a tailored treatment strategy.
- Intraoperative capsule damage of the GIST occurred during TAMIS.
Findings:
- Histopathological diagnosis confirmed a low-grade GIST.
- Immunostaining revealed the tumor was positive for c-kit, CD34, DOG-1, and α-SMA.
- The patient received neoadjuvant chemotherapy with imatinib for 3 months followed by TAMIS.
- Post-operative imatinib therapy was initiated due to intraoperative capsule damage.
Implications:
- TAMIS is a viable organ-preserving surgical option for selected rectal GIST cases.
- Neoadjuvant and adjuvant imatinib therapy can be effective in managing GIST, especially with intraoperative complications.
- This case highlights the successful integration of minimally invasive surgery and targeted therapy for rectal GIST.
