A Rare Case of a Giant Locally Advanced Stromal Tumor of the Stomach Made Resectable by Imatinib

Abstract

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. Most gastrointestinal soft tissue neoplasms, previously classified as leiomyomas, leiomyoblastomas, schwannomas or leiomyosarcomas, are now classified as GISTs on the basisof histology, molecular study and immunohistochemistry. They originate from the stem cells which differentiate toward the pacemaker cell (Interstitial cell of Cajal). Prognostic factors have been identified for GISTs,they include the tumor size and the mitotic rate. Surgery is the standard treatment for resectable GISTs. Metastatic and inoperable GISTs should consider medication with tyrosine kinase inhibitor (imatinib mesylate), which inhibits the c-kit receptor. We present the case of a locally advanced giant stromal tumor that became resectable after neoadjuvant chemotherapy with Imatinib; our work shows the importance of this molecule which can modify tumor status and surgical prognosis in locally advanced or metastatic GISTs.