[A Case of Unresectable Advanced Gastric Gastrointestinal Stromal Tumor (GIST) Successfully Controlled with Combined Surgical Treatment and Chemotherapy].

The patient was a woman in her 60s. Contrast-enhanced CT revealed a large, heterogeneously enhancing mass centered beneath the left diaphragm. A biopsy confirmed the diagnosis as gastric gastrointestinal stromal tumor (GIST), classified as cT4, N0, M1, clinical Stage Ⅳ. Treatment with imatinib at 400 mg/day was initiated. After 8 months the tumor appeared to shrink, and a PET scan was performed. The PET scan revealed localized FDG uptake in the ileocecal region only. Further investigation led to a diagnosis of colon cancer. With the possibility of resistance to treatment, surgical resection was planned together with ileo-cecal resection for colon cancer. Laparoscopy-assisted local gastrectomy, tumor resection combined splenectomy, and peritoneal nodules resection with omentectomy were performed. After surgery, patient continued imatinib again, and is alive without progression.