Sugiyama Y, Shimbara K, Sasaki M, Kouyama M, Tazaki T, Takahashi S, Nakamitsu A. Solitary peritoneal metastasis of gastrointestinal stromal tumor: A case report. World J Gastroenterol 2020; 26(36): 5527-5533 [PMID: 33024403 DOI: 10.3748/wjg.v26.i36.5527]
Corresponding Author of This Article
Yoichi Sugiyama, MD, PhD, Doctor, Surgeon, Surgical Oncologist, Department of Gastrointestinal Surgery, JA Hiroshima General Hospital, Jigozen 1-3-3, Hatsukaichi 738-8503, Japan. sugiyama0113@gmail.com
Research Domain of This Article
Surgery
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/
Yoichi Sugiyama, Kensuke Shimbara, Masaru Sasaki, Mohei Kouyama, Tatsuya Tazaki, Atsushi Nakamitsu, Department of Gastrointestinal Surgery, JA Hiroshima General Hospital, Hatsukaichi 738-8503, Japan
Shinya Takahashi, Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan
Author contributions: Sugiyama Y designed and wrote this report; Shimbara K participated in the surgery; Sasaki M, Kouyama M, Tazaki T, and Nakamitsu A reviewed the literature and contributed to drafting the manuscript; Takahashi S was responsible for the revision of the manuscript for important intellectual content; and all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Yoichi Sugiyama, MD, PhD, Doctor, Surgeon, Surgical Oncologist, Department of Gastrointestinal Surgery, JA Hiroshima General Hospital, Jigozen 1-3-3, Hatsukaichi 738-8503, Japan. sugiyama0113@gmail.com
Received: May 23, 2020 Peer-review started: May 23, 2020 First decision: June 20, 2020 Revised: July 28, 2020 Accepted: September 4, 2020 Article in press: September 4, 2020 Published online: September 28, 2020 Processing time: 124 Days and 0.3 Hours
Abstract
BACKGROUND
A gastrointestinal stromal tumor (GIST) is a mesenchymal tumor of the gastrointestinal tract that is most commonly found in the stomach. Recurrence of GISTs mostly occurs in the liver or peritoneum, and in most cases, multiple metastases occur. As a solitary peritoneal metastasis is rare, an appropriate treatment strategy has not been established. Here, we report a case of solitary peritoneal metastasis after complete resection of gastric GIST.
CASE SUMMARY
A 76-year-old woman was diagnosed with stomach GIST and underwent laparoscopic local resection using the CLEAN-NET method. As the recurrence risk was intermediate, adjuvant imatinib therapy was not administered. Two years after surgery, routine computed tomography revealed an abdominal mass between the dorsal side of the right hepatic lobe and right kidney. Other imaging tests did not reveal any abnormalities. Laparoscopic observation showed that the tumor was located at the retroperitoneum, and intraperitoneal dissemination was not found. Therefore, we performed laparoscopic tumor resection. Immunohistochemically, the tumor was positive for c-kit and CD34 and had a relatively high mitotic index and MIB-1 Labeling index. We administered adjuvant imatinib therapy. There was no evidence of recurrence 3 years after the operation.
CONCLUSION
This is the first reported case of a solitary recurrence of GIST in the peritoneum treated with complete laparoscopic resection.
Core Tip: Solitary peritoneal metastasis from a gastrointestinal stromal tumor is rare, and thus, there are no appropriate treatment strategies available. We report a rare case of solitary peritoneal metastasis of gastrointestinal stromal tumor in a 76-year-old woman. Complete laparoscopic resection of the tumor was performed. Moreover, adjuvant imatinib therapy was administered. There was no recurrence in the 3 years of follow-up.
