Published online Sep 28, 2020. doi: 10.3748/wjg.v26.i36.5527
Peer-review started: May 23, 2020
First decision: June 20, 2020
Revised: July 28, 2020
Accepted: September 4, 2020
Article in press: September 4, 2020
Published online: September 28, 2020
Processing time: 124 Days and 0.3 Hours
A gastrointestinal stromal tumor (GIST) is a mesenchymal tumor of the gastrointestinal tract that is most commonly found in the stomach. Recurrence of GISTs mostly occurs in the liver or peritoneum, and in most cases, multiple metastases occur. As a solitary peritoneal metastasis is rare, an appropriate treatment strategy has not been established. Here, we report a case of solitary peritoneal metastasis after complete resection of gastric GIST.
A 76-year-old woman was diagnosed with stomach GIST and underwent laparoscopic local resection using the CLEAN-NET method. As the recurrence risk was intermediate, adjuvant imatinib therapy was not administered. Two years after surgery, routine computed tomography revealed an abdominal mass between the dorsal side of the right hepatic lobe and right kidney. Other imaging tests did not reveal any abnormalities. Laparoscopic observation showed that the tumor was located at the retroperitoneum, and intraperitoneal dissemination was not found. Therefore, we performed laparoscopic tumor resection. Immunohistochemically, the tumor was positive for c-kit and CD34 and had a relatively high mitotic index and MIB-1 Labeling index. We administered adjuvant imatinib therapy. There was no evidence of recurrence 3 years after the operation.
This is the first reported case of a solitary recurrence of GIST in the peritoneum treated with complete laparoscopic resection.
Core Tip: Solitary peritoneal metastasis from a gastrointestinal stromal tumor is rare, and thus, there are no appropriate treatment strategies available. We report a rare case of solitary peritoneal metastasis of gastrointestinal stromal tumor in a 76-year-old woman. Complete laparoscopic resection of the tumor was performed. Moreover, adjuvant imatinib therapy was administered. There was no recurrence in the 3 years of follow-up.