Surgical second-look in high risk gastrointestinal stromal tumor of small intestine: A case report
| Autor: | Maria Abbondanza Pantaleo, Stefania Romano, Maria Giulia Pirini, Margherita Nannini, Salvatore Tondo, Fausto Catena, Lidia Gatto, Guido Biasco, Anna Mandrioli, Angelo Paolo Dei Tos, Maristella Saponara, Maria Caterina Pallotti, Antonio Daniele Pinna, Alessandra Maleddu, Cristian Lolli |
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| Přispěvatelé: | M. Nannini, M.A. Pantaleo, F. Catena, S. Romano, S. Tondo, M.G. Pirini, C. Lolli, A. Maleddu, A. Mandrioli, L. Gatto, M. Saponara, M. C. Pallotti, A. P. Dei To, A. D. Pinna, G. Biasco |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Cytoreductive surgery Gastrointestinal stromal tumors Peritoneal recurrence Second-look surgery Surgery Article Peritoneum medicine Stromal tumor High Risk Gastrointestinal Stromal Tumor neoplasms GiST business.industry medicine.disease Primary tumor digestive system diseases Small intestine Peritoneal carcinomatosis Clinical Practice medicine.anatomical_structure Radiology Gastrointestinal stromal tumor business |
| Popis: | INTRODUCTIONThe peritoneum is one of the most common sites of distant gastrointestinal stromal tumor (GIST) metastases. In particular, GIST arising from the small intestine with resected minimal synchronous macroscopic peritoneal carcinomatosis or with primary tumor rupture has a higher risk of developing peritoneal recurrence. Current clinical practice does not envisage second-look surgery in GIST patients at high risk of developing peritoneal recurrence, and no literature data are available.PRESENTATION OF CASEWe describe a 45-year-old woman who underwent emergency surgical resection of jejunal GIST presenting with spontaneous tumor rupture, synchronous ovarian and minimal macroscopic peritoneal involvement, and subsequent second-look surgery after 13 months of imatinib treatment.DISCUSSIONSecond-look surgery confirmed a 2.6cm lesion close to the mesenteric border of the fourth jejunal loop, and 11 peritoneal lesions with a macroscopic necrotic aspect related to treatment response. After conversion to an open procedure, a segmental jejunal resection was performed with removal of all peritoneal lesions and macroscopic radical cytoreduction.CONCLUSIONSecond-look surgery in selected GIST patients may be performed after at least 12 months of medical treatment with tyrosine-kinase inhibitors to identify those patients with limited peritoneal disease not disclosed by instrumental imaging who could undergo radical cytoreduction of peritoneal lesions. |
| Databáze: | OpenAIRE |
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