Long-term survival of a case with multiple liver metastases from duodenal gastrointestinal stromal tumor drastically reduced by the treatment with imatinib and hepatectomy

Figure 1 Clinical course of the patient illustrating the operations (pancreaticoduodenectomy for duodenal GIST and partial resection of recurrence tumor) and IM treatment.

Figure 2 Surgical specimen obtained by pancreaticoduodenectomy of the duodenal GIST.

Figure 3 Immunohistochemical analysis of the duodenal GIST. A: c-kit; B: CD34; C: S100; D: SMA.

Figure 4 Abdominal MRI showing multiple liver metastases and complete remission in response to imatinib therapy. Panel A: MRI images of the patient with multiple liver metastases after 3 mo of pancreaticoduodenectomy for malignant duodenal GIST; Panel B: Follow-up MRI images after 1 mo of oral imatinib therapy at 400 mg daily.

Figure 5 PET scan of liver metastases before and after imatinib treatment. A: pretreatment with imatinib; B: posttreatment with imatinib.

Figure 6 Abdominal CT and MRI showing recurrence of liver metastasis. A: CT; B: MRI.

Figure 7 Surgical specimen of partial hepatectomy for GIST recurrence. A: Operative findings; B: Resected specimens.