Primary Hepatic Epithelioid Gastrointestinal Stromal Tumor: A Rare Case

Primary hepatic epithelioid gastrointestinal stromal tumor (GIST) is an extremely rare neoplasm. Due to its non‑specific clinical and radiologic features, it is frequently misdiagnosed as other primary or metastatic hepatic malignancies. Here, we report the case of an 85‑year‑old asymptomatic woman in whom a mass in the left hepatic lobe was incidentally identified during routine examination. Computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography‑CT revealed a well‑defined malignant lesion in the left hepatic lobe without evidence of extrahepatic disease. The patient underwent neoadjuvant transarterial chemoembolization (TACE), followed by left hemihepatectomy one month later. Histopathologic and immunohistochemical analyses confirmed a high‑risk epithelioid GIST. Adjuvant therapy with oral imatinib (400 mg/day) was initiated six weeks postoperatively. At the 10‑month follow‑up, the patient remained free of tumor recurrence. Despite preoperative diagnostic challenges, the combination of neoadjuvant TACE, curative surgical resection, and adjuvant imatinib resulted in favorable short‑term outcomes in this patient.