Imatinib as adjuvant therapy for high risk GIST: a case report

Abstract

We here report a case of 42 years old man who experienced sudden abdominal cramps and then underwent explorative laparotomy because of the CT-finding of a 23 cm abdominal mass at the stomach. Frozen specimen analysis indicated a probable gastrointestinal stromal tumor (GIST). Radical excision was performed. Definitive pathological analysis revealed a CD34 and CD 117(c-KIT) positive GIST with a mitotic count of 15/50 HPF. These features indicate a disease with an high risk of recurrence within few years. Molecular analysis found a WK557-558 deletion of c-KIT exon 11, that indicates a poor prognosis in patients with completely resected GIST. In april 2010 he started adjuvant therapy with imatinib at standard dose of 400 mg/day that was well tolerated: he reported only G1 periocular edema and conjunctivitis. Considering the risk of disease recurrence he continued adjuvant therapy beyond the first year.