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Gastrointestinal stromal tumor of the rectum resected by transanal total mesorectal excision after neoadjuvant imatinib treatment: A case report
Author(s) -
Yano Takuya,
Nakahara Masahiro,
Okuda Hiroshi,
Nishidate Toshihiko,
Takemasa Ichiro,
Fujimori Masahiko,
Nakatsuka Hirofumi,
Amano Hironobu,
Ohdan Hideki,
Noriyuki Toshio
Publication year - 2020
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12782
Subject(s) - medicine , gist , total mesorectal excision , stromal tumor , rectum , neoadjuvant therapy , imatinib mesylate , biopsy , surgery , imatinib , stromal cell , radiology , colorectal cancer , cancer , myeloid leukemia , breast cancer
This report describes the combination of a transanal total mesorectal excision (TaTME) and neoadjuvant therapy with Imatinib mesylate (IM) for a gastrointestinal stromal tumor (GIST) of the lower rectum. A 49‐year‐old man presented with a submucosal tumor with ulcer located 3 cm above the anal verge. Histopathologically, a biopsy showed spindle‐shape cells, positive for C‐kit and CD34, negative for smooth muscle actin, desmin and S‐100 protein. Genetically, this GIST had the mutation in KIT exon 11. IM (400 mg/d) was administered as neoadjuvant therapy for 80 days. The GIST shrank from 4.7 to 3.3 cm in diameter. Abdominal and transanal approach were started at the same time. The tumor was resected by TaTME successfully. The manometric pressure data and anal function were preserved before and after surgery. TaTME and neoadjuvant therapy with IM provide a treatment option which can preserve anal function for the lower rectal GIST.