Surgery Combined with Molecular Targeted Therapy Successfully Treated Giant Esophageal Gastrointestinal Stromal Tumor
Mengjie Li, Jun Wei, Guihua Xu, Ying Liu, Jian Zhu
Abstract
Gastrointestinal stromal tumors (GISTs) are rare neoplasms arising from mesenchymal cells of the digestive tract and abdomen. Only a few isolated cases of giant esophageal GISTs (greater than 5 cm in size) have been reported with clinical features and surgical methods. Radical esophagectomy with negative margins, followed by gastric tube reconstruction, is recommended for giant esophageal GISTs. However, patients undergoing this type of surgery experienced a sharp decrease in food intake (due to the removal of most of the stomach) and were prone to eating regurgitation, resulting in poor quality of life. We describe the case of a 65-year-old man with a 16.3-cm giant esophageal GIST. The results of frozen quick pathology during the operation indicated an esophageal stromal tumor. Only resection of the esophageal mass was performed upon no consent for esophageal resection by family members. The patient received oral treatment with 400 mg of imatinib once daily after the operation. After 3 years of follow-up, the patient showed no signs of recurrence or metastasis. The successful management of this case suggests that molecular targeted therapy after surgery would avoid giant esophageal GIST recurrence. Therefore, giant esophageal GISTs probably do not need radical esophagectomy with negative margins, followed by gastric tube reconstruction.