MDT discussion of a case of giant gastrointestinal stromal tumor_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Kaimin , QIAN Shidong ,  CHEN Gang

The Second Department of Hepatopancreatobiliary Surgery, The First Hospital of Kunming, Kunming 650011, P. R. China;

Corresponding?author：

CHEN Gang, Email: kmcg123@163.com

Keywords：

gastrointestinal stromal tumor; multidisciplinary diagnosis and treatment

DOI：

10.7507/1007-9424.201906097

Video：

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Objective To explore the clinical characteristics, diagnosis, and treatment norms of gastrointestinal stromal tumor, so as to deepen clinicians’ understanding of the gastrointestinal stromal tumor and avoid misdiagnosis.Methods The clinical data of a patient with gastrointestinal stromal tumor who treated in March 2019 in The First Hospital of Kunming was retrospectively analyzed, and determining the methods of the treatment through MDT mode.Results This patient was generally in good condition. After MDT discussions among the imaging department, cardiothoracic surgery department, oncology department, and anesthesia department, it was considered that surgical treatment was the best treatment scheme. The operation time was 120 min, intraoperative bleeding was about 100 mL, and no blood transfusion was performed. No bleeding, abdominal infection, gastroesophageal reflux, and other complications occurred after the operation, and the patient was discharged successfully on the 10^th day after the operation. Postoperative treatment was assisted by imatinib. Follow-up was conducted for more than 4 months, with no obvious complication occurred after discharge, so continued to follow-up.Conclusion Gastrointestinal stromal tumor can be diagnosed and treated by multidisciplinary approach, and surgical resection is still the most important and effective treatment.

Citation： LIU Kaimin, QIAN Shidong, CHEN Gang. MDT discussion of a case of giant gastrointestinal stromal tumor. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(2): 192-195. doi: 10.7507/1007-9424.201906097 Copy

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2.	Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol, 2002, 33(5): 459-465.
3.	侯英勇, 王堅, 朱雄增, 等. 胃腸道間質瘤 76例的臨床病理及免疫組織化學特征. 中華病理學雜志, 2002, 31(1): 20-25.
4.	Miettinen M, Lasota J. KIT (CD117): a review on expression in normal and neoplastic tissues, and mutations and their clinicopathologic correlation. Appl Immunohistochem Mol Morphol, 2005, 13(3): 205-220.
5.	賀慧穎, 方偉崗, 鐘鎬鎬, 等. 165例胃腸道間質瘤中 c-kit和PDGFRA基因突變的檢測及臨床診斷意義. 中華病理學雜志, 2006, 35(5): 262-266.
6.	Wada N, Kurokawa Y, Takahashi T, et al. Detecting secondary cKIT mutations in the peripheral blood of patients with imatinibresistant gastrointestinal stromal tumor. Oncology, 2016, 90(2): 112-117.
7.	Gao J, Li J, Li Y, et al. Intratumoral KIT mutational heterogeneity and recurrent KIT/PDGFRA mutations in KIT/PDGFRAwild-type gastrointestinal stromal tumors. Oncotarget, 2016, 7(21): 30241-30249.
8.	曹暉, 高志冬, 何裕隆, 等. 胃腸間質瘤規范化外科治療中國專家共識(2018版). 中國實用外科雜志, 2018, 38(9): 965-973.
9.	徐澤寬, 徐皓, 李灃員. 腹腔鏡技術在胃腸間質瘤手術中的應用價值與爭議. 中國實用外科雜志, 2018, 38(5): 501-504.
10.	Bischof DA, Kim Y, Dodson R, et al. Open versus minimally invasive resection of gastric GIST : a multi-institutional analysis of short- and long- term outcomes. Ann Surg Oncol, 2014, 21(9): 2941-2948.
11.	Honda M, Hiki N, Nunobe S, et al. Long-term and surgical outcomes of laparoscopic surgery for gastric gastrointestinal stromal tumors. Surg Endosc, 2014, 28(8): 2317-2322.
12.	Shoji Y, Takeuchi H, Goto O, et al. Optimal minimally invasive surgical procedure for gastric submucosal tumors. Gastric Cancer, 2018, 21(3): 508-515.
13.	Yin Y, Xiang J, Tang S, et al. A lower dosage of imatinib in patients with gastrointestinal stromal tumors with toxicity of the treatment. Medicine (Baltimore), 2016, 95(49): e5488.
14.	徐皓, 馬利林, 徐為, 等. 胃腸間質瘤病人服藥前后監測伊馬替尼血漿濃度意義的中國多中心研究. 中華胃腸外科雜志, 2016, 19(11): 1271-1276.

1. 中國胃腸道間質瘤專家組. 中國胃腸道間質瘤診斷治療共識(2008 年版). 臨床腫瘤學雜志, 2009, 14(8): 746.
2. Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol, 2002, 33(5): 459-465.
3. 侯英勇, 王堅, 朱雄增, 等. 胃腸道間質瘤 76例的臨床病理及免疫組織化學特征. 中華病理學雜志, 2002, 31(1): 20-25.
4. Miettinen M, Lasota J. KIT (CD117): a review on expression in normal and neoplastic tissues, and mutations and their clinicopathologic correlation. Appl Immunohistochem Mol Morphol, 2005, 13(3): 205-220.
5. 賀慧穎, 方偉崗, 鐘鎬鎬, 等. 165例胃腸道間質瘤中 c-kit和PDGFRA基因突變的檢測及臨床診斷意義. 中華病理學雜志, 2006, 35(5): 262-266.
6. Wada N, Kurokawa Y, Takahashi T, et al. Detecting secondary cKIT mutations in the peripheral blood of patients with imatinibresistant gastrointestinal stromal tumor. Oncology, 2016, 90(2): 112-117.
7. Gao J, Li J, Li Y, et al. Intratumoral KIT mutational heterogeneity and recurrent KIT/PDGFRA mutations in KIT/PDGFRAwild-type gastrointestinal stromal tumors. Oncotarget, 2016, 7(21): 30241-30249.
8. 曹暉, 高志冬, 何裕隆, 等. 胃腸間質瘤規范化外科治療中國專家共識(2018版). 中國實用外科雜志, 2018, 38(9): 965-973.
9. 徐澤寬, 徐皓, 李灃員. 腹腔鏡技術在胃腸間質瘤手術中的應用價值與爭議. 中國實用外科雜志, 2018, 38(5): 501-504.
10. Bischof DA, Kim Y, Dodson R, et al. Open versus minimally invasive resection of gastric GIST : a multi-institutional analysis of short- and long- term outcomes. Ann Surg Oncol, 2014, 21(9): 2941-2948.
11. Honda M, Hiki N, Nunobe S, et al. Long-term and surgical outcomes of laparoscopic surgery for gastric gastrointestinal stromal tumors. Surg Endosc, 2014, 28(8): 2317-2322.
12. Shoji Y, Takeuchi H, Goto O, et al. Optimal minimally invasive surgical procedure for gastric submucosal tumors. Gastric Cancer, 2018, 21(3): 508-515.
13. Yin Y, Xiang J, Tang S, et al. A lower dosage of imatinib in patients with gastrointestinal stromal tumors with toxicity of the treatment. Medicine (Baltimore), 2016, 95(49): e5488.
14. 徐皓, 馬利林, 徐為, 等. 胃腸間質瘤病人服藥前后監測伊馬替尼血漿濃度意義的中國多中心研究. 中華胃腸外科雜志, 2016, 19(11): 1271-1276.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

MDT discussion of a case of giant gastrointestinal stromal tumor

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