Abstract
BackgroundResection of a gastrointestinal stromal tumor (GIST) of the rectum can be difficult because of the particular location in the pelvis, and a large rectal GIST often requires abdominoperineal resection. Recent reports demonstrate that neoadjuvant imatinib treatment improves surgical outcomes in patients with a rectal GIST, and there are only a few reports of the effectiveness of laparoscopic surgery for a rectal GIST.Case presentationA 46-year-old man was found to have a rectal GIST that measured 80 mm and was located on the anterior wall of the lower rectum. After 6 months treatment with imatinib, the tumor decreased in size to 37 mm, and laparoscopic low anterior resection was performed. The patient is currently alive without any evidence of recurrence 37 months after surgery.ConclusionsNeoadjuvant imatinib should be a treatment of choice for a large rectal GIST. When marked tumor shrinkage is achieved, laparoscopic surgery may be the preferred procedure.
Highlights
Resection of a gastrointestinal stromal tumor (GIST) of the rectum can be difficult because of the particular location in the pelvis, and a large rectal Gastrointestinal stromal tumors (GISTs) often requires abdominoperineal resection
Neoadjuvant imatinib should be a treatment of choice for a large rectal GIST
Complete surgical excision with histologically negative margins is the primary treatment of choice for localized GISTs, resection of rectal GISTs can be difficult in the narrow pelvic space, and a large rectal GIST has a risk of rupture during surgery and often requires abdominoperineal resection
Summary
Neoadjuvant imatinib should be a treatment of choice for large rectal GIST to increase the chance of anal preservation, and achieve surgical safety. When dramatic tumor shrinkage is obtained, laparoscopic surgery may be the preferred procedure. Consent Written informed consent was obtained from the patient for publication of this Case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. MN, KO, TS, AM, HK, MS, TN, and HY reviewed the manuscript. All authors read and approved the final manuscript. Author details 1Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka 426-8677, Japan. Author details 1Department of Surgery, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka 426-8677, Japan. 2Department of Pathology, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan. 3Department of Pathology, Fujieda Municipal General Hospital, 4-1-11 Surugadai, Fujieda, Shizuoka 426-8677, Japan
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