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Gastrointestinal stromal tumor (以下，GIST)に対する治療の第一選択は，外科的完全切除である．術前補助療法の意義は確立されていないが，いわゆるMarginally resectableと表現されるGISTは，完全切除が不可能になる可能性があり，手術自体のリスクや術後合併症の頻度が高く再発率も高いが，そういった症例には術前イマチニブ投与が有効と近年多くの報告がみられ...ている．今回術前イマチニブ投与により拡大手術を行うことなく完全切除しえた巨大十二指腸GISTの症例を経験したので文献的考察を加えて報告する．
A case was a 77 years old male. Exertional breathlessness was a chief complaint, and anemia was pointed out. A duodenum GIST was detected by gastroscopy. The CT scan showed infiltration in an inferior vena cava, the right kidney, and an ascending colon, so we judged that radical cure resection was difficult. We started Imatinib medication. Six months after the medication start, because the border with surroundings also became clear, we became a plan of the operation. The tumor existed in the descending limb of duodenum and the distance with papilla Vater was maintained, so the complete excision by duodenal portion resection was possible for it. Although meaning of primary systemic therapy for GIST was not established, it was shown that medicating Imatinib to the high-level partial advance GIST before an operation may become an effective cure which avoids an extended operation and makes complete resection of a tumor possible.続きを見る
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