CASE REPORT

Gastrointestinal stromal tumour treated with neoadjuvant imatinib

M B Loughrey¹, C Mitchell¹, G B Mann², M Michael³ and P M Waring¹

¹ Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC 3002, Australia
² Department of Surgical Oncology, Peter MacCallum Cancer Centre
³ Department of Medical Oncology, Peter MacCallum Cancer Centre

Correspondence to:
Correspondence to:
Dr M B Loughrey
Department of Pathology, Peter MacCallum Cancer Centre, St Andrew’s Place, East Melbourne, VIC 3002, Australia; mauriceloughrey{at}doctors.org.uk

This report describes a case of unresectable primary gastrointestinal stromal tumour (GIST) treated with imatinib on a neoadjuvant basis, before subsequent successful surgical resection. After six months of imatinib, computed tomography and positron emission tomography imaging demonstrated a significant size reduction and complete metabolic response to treatment, rendering the tumour resectable. Mutational analysis showed an activating KIT mutation in exon 11. The pathological appearance of the resected tumour was heterogeneous with extensive necrosis, cystic and myxoid change, extensive hypocellularity, and patchy foci of residual viable tumour. The implications for this management option of radiological, pathological, and molecular assessment are discussed.

Abbreviations: CT, computed tomography; GIST, gastrointestinal stromal tumour; PET, positron emission tomography

Keywords: gastrointestinal stromal tumour; imatinib; neoadjuvant

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Haller, F., Detken, S., Schulten, H.-J., Happel, N., Gunawan, B., Kuhlgatz, J., Fuzesi, L. (2007). Surgical Management After Neoadjuvant Imatinib Therapy in Gastrointestinal Stromal Tumours (GISTs) with Respect to Imatinib Resistance Caused by Secondary KIT Mutations. Ann. Surg. Oncol. 14: 526-532 [Abstract] [Full Text]