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タイトル: 術前イマチニブ投与により手術が可能となった骨盤内GISTの1例
その他のタイトル: Successful Resection of a Gastrointestinal Stromal Tumor in the Pelvis with Imatinib Mesylate as Neoadjuvant Therapy
著者: 中島, 信幸  KAKEN_name
加藤, 成一  KAKEN_name
臼井, 幸男  KAKEN_name
篠崎, 哲男  KAKEN_name
添田, 宗市  KAKEN_name
川上, 正能  KAKEN_name
金, 伯士  KAKEN_name
花井, 一也  KAKEN_name
星, 昭夫  KAKEN_name
野本, 剛史  KAKEN_name
寺地, 敏郎  KAKEN_name
貞廣, 荘太郎  KAKEN_name
著者名の別形: Nakajima, Nobuyuki
Kato, Seiichi
Usui, Yukio
Shinozaki, Tetsuo
Soeda, Shuichi
Kawakami, Masayoshi
Kim, Hakushi
Hanai, Kazuya
Hoshi, Akio
Nomoto, Takeshi
Terachi, Toshiro
Sadahiro, Sotaro
キーワード: GIST
Neoadjuvant therapy
Imatinib mesylate
Surgical resection
発行日: 31-Mar-2011
出版者: 泌尿器科紀要刊行会
誌名: 泌尿器科紀要
巻: 57
号: 3
開始ページ: 135
終了ページ: 139
抄録: We report a case of marginally resectable gastrointestinal stromal tumor (GIST) in the pelvis treated with neoadjuvant intent before subsequent successful surgical resection. A 46-year old man presented with urinary frequency and rectal discomfort with tenesmus. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a 12 cm diameter mass between the bladder and rectum and the margin of the tumor and prostate was unclear. No metastases were evident. Trans-rectal needle core biopsy confirmed c-kit positive GIST. Because of the locally advanced nature of the tumor, immediate surgical resection would have required total pelvic exenteration with eternal colostomy and urinary diversion. Therefore, the patient was treated with imatinib mesylate 400 mg daily in anticipation of adequate tumor size reduction to enable a more simplified surgical approach. After 3 months of imatinib therapy, MRI demonstrated a reduction in tumor size of 60%. Consequently, a complete surgical resection including the bladder, prostate and part of the sigmoid colon with temporary ileostomy and ileal conduit was performed. Pathological findings of the resected specimen showed widespread degeneration with cystic changes, necrosis, and hypocellularlity, as well as nodules of residual viable c-kit positive tumor cells. The patient has been treated with imatinib mesylate for 39 months following the operation without tumor recurrence.
著作権等: 許諾条件により本文は2012-04-01に公開
URI: http://hdl.handle.net/2433/139605
PubMed ID: 21586885
出現コレクション:Vol.57 No.3

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