Large esophageal gastrointestinal stromal tumors resected thoracoscopically after oral imatinib therapy: a report of two cases

Clin J Gastroenterol. 2023 Apr;16(2):136-141. doi: 10.1007/s12328-022-01743-0. Epub 2022 Dec 22.

Abstract

Esophageal gastrointestinal stromal tumors (GISTs) are very rare, accounting for 2-5% of all GISTs. As with other GISTs, the principle of surgical treatment is complete resection with negative margins. In addition to biological grades of GISTs itselves, local recurrence due to capsular damage is a known risk. We describe two cases of massive esophageal GISTs that were successfully resected thoracoscopically after 2 months administration of 400 mg imatinib, with some discussion of the literature. Case 1, the patient was a 51-years-old man. After treated with 400 mg of imatinib as preoperative chemotherapy for 2 months, we performed surgery that included right thoracoscopic subtotal esophagectomy, gastric tube reconstruction, and jejunostomy. The resection specimen and histopathology were esophageal GIST-LtMtAeG, 110 × 95 mm. The postoperative course was uneventful, and was discharged on postoperative day 14. The patient has been recurrence free for 11 months postoperatively. Case 2, the patient was a 70-years-old man. After treated with 400 mg of imatinib as preoperative chemotherapy for 2 months, we performed surgery that included right thoracoscopic subtotal esophagectomy, gastric tube reconstruction, and jejunostomy. The resection specimen and histopathology were esophageal GIST-LtAeG, 90 × 52 mm. The postoperative course was uneventful, and was discharged on postoperative day 14. The patient has been recurrence free for 9 months postoperatively.

Keywords: Esophagus; Gastrointestinal stromal tumor; Thoracoscopy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents* / therapeutic use
  • Esophageal Neoplasms* / drug therapy
  • Esophageal Neoplasms* / pathology
  • Esophageal Neoplasms* / surgery
  • Esophagectomy
  • Gastrointestinal Stromal Tumors* / diagnostic imaging
  • Gastrointestinal Stromal Tumors* / drug therapy
  • Gastrointestinal Stromal Tumors* / surgery
  • Humans
  • Imatinib Mesylate / therapeutic use
  • Male
  • Middle Aged

Substances

  • Imatinib Mesylate
  • Antineoplastic Agents