Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 21, 2009; 15(15): 1910-1913
Published online Apr 21, 2009. doi: 10.3748/wjg.15.1910
Imatinib mesylate neoadjuvant treatment for rectal malignant gastrointestinal stromal tumor
Ying-Yong Hou, Yang Zhou, Shao-Hua Lu, Wei-Dong Qi, Cheng Xu, Jun Hou, Yun-Shan Tan
Ying-Yong Hou, Yang Zhou, Shao-Hua Lu, Wei-Dong Qi, Cheng Xu, Jun Hou, Yun-Shan Tan, Department of Pathology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China
Author contributions: Hou YY and Zhou Y contributed equally to this work; Hou YY, Zhou Y, Lu SH, Hou J, Tan YS designed the research; Qi WD and Xu C performed the research; Hou YY and Zhou Y analyzed the data; and Hou YY and Zhou Y wrote the paper.
Correspondence to: Yun-Shan Tan, Department of Pathology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China. tan10794ys@yahoo.com.cn
Telephone: +86-21-64041990-2732
Fax: +86-21-64038472
Received: December 27, 2008
Revised: March 5, 2009
Accepted: March 12, 2009
Published online: April 21, 2009
Abstract

Surgical treatments including radical resection and local excision remain the main treatment for primary rectal gastrointestinal stromal tumors (GISTs). However, since patients with high-grade rectal GISTs have a higher risk of tumor recurrence and a shorter life expectancy, neoadjuvant treatment is necessary. In this case report, the efficacy of imatinib mesylate (IM) as a neoadjuvant therapy was assessed in an old man with malignant rectal GIST. The patient received IM preoperative treatment for a short period of one and a half months; at the end of the IM treatment, computed tomography scanning showed a markedly reduced tumor size and cystic changes of the tissue. At that time, a function sphincter-sparing surgery was performed. The histological examination of the resected specimen detected no tumor cells, but residual blood vessels and scattered inflammatory lymphocytes. After surgery, the patient has been followed up without additional IM treatment and remained disease-free for 57 mo. This case indicates that IM neoadjuvant therapy can dramatically improve the prognosis of rectal malignant GIST.

Keywords: Gastrointestinal stromal tumor; Imatinib mesylate; Neoadjuvant