Laparoscopic resection of a gastrointestinal stromal tumor of the lower rectum in a patient with coronary artery disease following long-term neoadjuvant imatinib treatment and anticoagulation therapy

World Journal of Surgical Oncology

Toshiaki Watanabe²  Issei Komuro³  Masako Ikemura¹  Joji Kitayama²  Eiji Sunami²  Soichiro Ishihara²  Masao Takahashi³  Toshiaki Tanaka²  Takamitsu Kanazawa²  Hiroaki Nozawa² 

[1] Department of Pathology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan

关键词: Percutaneous coronary intervention;    Laparoscopic surgery;    Imatinib;    Gastrointestinal stromal tumor;    Anti-platelet therapy;   

Others  :  1148767
DOI  :  10.1186/1477-7819-12-211

 received in 2014-02-01, accepted in 2014-07-04,  发布年份 2014

【 摘 要 】

Surgery is the mainstay of treatment for gastrointestinal stromal tumors (GISTs). However, complete resection of rectal GISTs is sometimes difficult because of bulkiness and/or anatomical reasons. Neoadjuvant imatinib therapy has gained attention as an alternative treatment to increase the chance of en bloc resection of rectal GISTs, although it usually takes several months. In this case report, we first demonstrated that neoadjuvant imatinib therapy can be performed safely not only to downsize tumors, but also to allow adequate time for the effective treatment of major comorbid illnesses. A 74-year-old man was diagnosed with a 45 mm GIST of the lower rectum. He also had severe stenosis in the proximal segment of the left anterior descending coronary artery. Following the implantation of a drug-eluting stent, the patient received imatinib together with dual anti-platelet therapy for 12 months without obvious side effects. Follow-up image studies revealed tumor shrinkage as well as stent patency. En bloc resection of the GIST was performed laparoscopically, which preserved the anus. The patient is currently alive without any evidence of relapse for 12 months after surgery.

【 授权许可】

   
2014 Nozawa et al.; licensee BioMed Central Ltd.

【 图 表 】

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