Lin XK, Zhang Q, Yang WL, Shou CH, Liu XS, Sun JY, Yu JR. Primary gastrointestinal stromal tumor of the liver treated with sequential therapy. World J Gastroenterol 2015; 21(8): 2573-2576 [PMID: 25741171 DOI: 10.3748/wjg.v21.i8.2573]
Corresponding Author of This Article
Ji-Ren Yu, MD, Director, Department of Gastrointestinal Surgery, the First Affiliated Hospital, Medical College, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. yujr0909@zju.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xian-Ke Lin, Qing Zhang, Wei-Li Yang, Chun-Hui Shou, Xiao-Sun Liu, Jian-Yi Sun, Ji-Ren Yu, Department of Gastrointestinal Surgery, the First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Yu JR designed the research; Lin XK performed the research and wrote the manuscript; Zhang Q collected the clinical patient data; Yang WL performed the genetic analyses; Liu XS reviewed the manuscript; Shou CH analyzed the data; and Sun JY completed the follow-up visit.
Supported by A grant from the National Natural Science Foundation of China, No. 81273254/H1006.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ji-Ren Yu, MD, Director, Department of Gastrointestinal Surgery, the First Affiliated Hospital, Medical College, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. yujr0909@zju.edu.cn
Telephone: +86-571-87236147 Fax: +86-571-87072577
Received: May 23, 2014 Peer-review started: May 26, 2014 First decision: July 9, 2014 Revised: July 21, 2014 Accepted: September 16, 2014 Article in press: September 16, 2014 Published online: February 28, 2015
Abstract
A 67-year-old female presented with a primary hepatic gastrointestinal stromal tumor that was detected by computed tomography and diagnosed based on histopathological and genetic analyses. The tumor was microscopically composed of spindle cells and epithelioid cells, and immunohistochemistry results showed positive staining for CD117 and CD34 expression. A genetic analysis revealed a heterozygous point mutation and deletion in exon 11 of c-KIT. After an R0 resection, imatinib mesylate was administered for 1 year until its use was discontinued due to severe side effects. Two years after the original operation, the tumor recurred in the residual liver and was completely resected again. Imatinib mesylate was administered for 2 years until it was replaced by sunitinib malate because of disease progression. The patient has survived for 53 mo after undergoing a sequential therapy consisting of surgical excision, imatinib and sunitinib.
Core tip: The tumor was detected by computed tomography and diagnosed based on histopathological and genetic analyses. Metastases from gastrointestinal stromal tumors were excluded using computed tomography, ultrasound, esophagogastroduodenoscopy and colonoscopy. The patient was treated with an extended sequential therapy consisting of surgery, imatinib mesylate, and sunitinib malate. The patient has survived for 53 mo after the start of therapy.
