Giant gastrointestinal stromal tumor of the vermiform appendix: A case report

Kaneko,Manabu; Kawai,Kazushige; Murono,Koji; Nishikawa,Takeshi; Sasaki,Kazuhito; Otani,Kensuke; Yasuda,Koji; Tanaka,Toshiaki; Kiyomatsu,Tomomichi; Hata,Keisuke; Nozawa,Hiroaki; Ishihara,Soichiro; Hayashi,Akimasa; Shinozaki‑Ushiku,Aya; Fukayama,Masashi; Watanabe,Toshiaki

doi:10.3892/mco.2017.1334

Giant gastrointestinal stromal tumor of the vermiform appendix: A case report

Authors:
- Manabu Kaneko
- Kazushige Kawai
- Koji Murono
- Takeshi Nishikawa
- Kazuhito Sasaki
- Kensuke Otani
- Koji Yasuda
- Toshiaki Tanaka
- Tomomichi Kiyomatsu
- Keisuke Hata
- Hiroaki Nozawa
- Soichiro Ishihara
- Akimasa Hayashi
- Aya Shinozaki‑Ushiku
- Masashi Fukayama
- Toshiaki Watanabe
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Affiliations: Department of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo 113‑8655, Japan, Department of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo 113‑8655, Japan
Published online on: July 19, 2017 https://doi.org/10.3892/mco.2017.1334
Pages: 399-403

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Abstract

Gastrointestinal stromal tumors (GISTs) of the vermiform appendix are rare, measuring <3 cm in 82.4% of the reported cases. Neoadjuvant therapy with the receptor tyrosine kinase inhibitor imatinib mesylate has the potential to improve resectability and organ preservation rates in locally advanced or metastatic/recurrent GISTs. We herein report the case of a 67‑year‑old male patient with an unusually large GIST (22 cm in diameter) of uncertain origin in the right lower abdominal quadrant, with a solitary peritoneal metastasis. Due to the size of this GIST and presence of metastatic disease, neoadjuvant therapy with imatinib (400 mg/day orally) was administered. Follow‑up imaging studies revealed marked shrinkage of the primary and metastatic tumors. Subsequently, laparoscopic exploration revealed that the main tumor originated from the tip of the vermiform appendix, and that the peritoneal metastasis was located in the ascending mesocolon. The patient underwent laparoscopic appendectomy and excision of the peritoneal metastasis, without tumor rupture. Therefore, in appropriately selected patients, neoadjuvant imatinib for borderline resectable or oligometastatic GISTs may be a reasonable choice.

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