内容紹介
Summary
A 66-year-old man was referred to our hospital after being diagnosed with a pelvic tumor. A subsequent transperineal biopsy revealed spindle cells with CD34・c-kit(+). An enhanced computed tomography scan showed a giant rectal-derived tumor in the pelvis. The tumor was pressing on the urinary bladder and the prostate, and appeared to invade the posterior wall of these organs. The patient was diagnosed with rectal GIST, and neoadjuvant therapy with 400 mg/day imatinib was initiated. Three months later, the tumor reduction rate was at 33.6%, and surgery was performed. The operative method applied was pelvic exenteration and ileal conduit, for local R0 resection. The patient has remained recurrence free for 2.5 years since the surgery.
要旨
症例は66歳,男性。前医より前立腺腫瘍の疑いで当院へ紹介となった。経会陰針生検にてCD34・c-kitが陽性の紡錘形細胞を認めた。腹部造影CT検査では骨盤内に巨大腫瘍を認めた。膀胱・前立腺は圧排され,後壁浸潤が疑われた。直腸原発gastrointestinal stromal tumor(GIST)と診断し,imatinib(IM)400 mg/day連日投与による術前化学療法を施行した。3か月後の縮小率は33.6%で,その時点で手術の方針となった。R0手術を優先し,骨盤内臓全摘術,回腸導管造設術を施行した。現在,術後2年6か月経過しているが,無再発生存中である。
目次
A 66-year-old man was referred to our hospital after being diagnosed with a pelvic tumor. A subsequent transperineal biopsy revealed spindle cells with CD34・c-kit(+). An enhanced computed tomography scan showed a giant rectal-derived tumor in the pelvis. The tumor was pressing on the urinary bladder and the prostate, and appeared to invade the posterior wall of these organs. The patient was diagnosed with rectal GIST, and neoadjuvant therapy with 400 mg/day imatinib was initiated. Three months later, the tumor reduction rate was at 33.6%, and surgery was performed. The operative method applied was pelvic exenteration and ileal conduit, for local R0 resection. The patient has remained recurrence free for 2.5 years since the surgery.
要旨
症例は66歳,男性。前医より前立腺腫瘍の疑いで当院へ紹介となった。経会陰針生検にてCD34・c-kitが陽性の紡錘形細胞を認めた。腹部造影CT検査では骨盤内に巨大腫瘍を認めた。膀胱・前立腺は圧排され,後壁浸潤が疑われた。直腸原発gastrointestinal stromal tumor(GIST)と診断し,imatinib(IM)400 mg/day連日投与による術前化学療法を施行した。3か月後の縮小率は33.6%で,その時点で手術の方針となった。R0手術を優先し,骨盤内臓全摘術,回腸導管造設術を施行した。現在,術後2年6か月経過しているが,無再発生存中である。