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Vol. 76. Issue 4.
Pages 264-267 (October 2004)
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Vol. 76. Issue 4.
Pages 264-267 (October 2004)
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Tumor estromal del tracto gastrointestinal
Gastrointestinal stromal tumor
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Eva María Carbajo-Ferréa,1
Corresponding author
ddelcastillo@grupsagessa.com

Correspondencia: Hospital Universitari Sant Joan de Reus. Sant Joan, s/n. 43201. Reus. Tarragona. España.
, Jesús Sánchez-Péreza, Antonio Sánchez-Marína, Joan Doménech-Calveta, María Ángeles Martínez-Lanaob, Vicente Valentí-Morenoc, Daniel del Castillo-Déjardina
a Servicio de Cirugía General. Hospital Universitario Sant Joan de Reus. Facultad de Medicina i Ciencies de la Salud. Universitat Rovira i Virgili. Reus. Tarragona.
b Servicio de Anatomía Patológica. Hospital Universitario Sant Joan de Reus, Facultad de Medicina i Ciencies de la Salud. Universitat Rovira i Virgili. Reus. Tarragona.
c Servicio de Oncología. Hospital Universitario Sant Joan de Reus, Facultad de Medicina i Ciencies de la Salud. Universitat Rovira i Virgili. Reus. Tarragona. España.
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Resumen

El tumor estromal del tracto gastrointestinal es una entidad poco frecuente y con pocos casos descritos en la bibliografía. Su manejo hasta hace poco era exclusivamente quirúrgico, si bien en la actualidad, en tumores de alto grado cabe la posibilidad de realizar exéresis amplias, ya no sólo con intención paliativa, sino para dar lugar al tratamiento posterior con imatinib mesilato, un fármaco que ha revolucionado y dado esperanza al tratamiento de estos tumores por la elevada tasa de remisiones y su buena tolerancia. Se presenta el caso de una paciente afectada de un tumor estromal del tracto gastrointestinal (GIST) de alto grado en el que la combinación de la cirugía radical y de la terapia farmacológica nos permiten hablar de remisión de enfermedad hasta el día de hoy, 7 meses después de su detección y tratamiento.

Palabras Clave:
Tumor estromal del tracto gastrointestinal (GIST)
Imatinib mesilato
Cirugía

Gastrointestinal stromal tumor (GIST) is a highly infrequent tumor and few cases have been reported in the literature. Until recently, its management was exclusively surgical. However, in high-grade tumors wide excisions are currently a possibility, not only with palliative goals, but also to continue with medical treatment with imatinib mesylate, a new drug which has revolutionized management and aroused new hope, because of the high rate of cures and its good tolerance. We describe the case of a patient with a high grade GIST, in which a combination of surgery and medical treatments produced remission of the disease that has lasted to date, 7 months later.

Key Words:
Gastrointestinal Stromal Tumor (GIST)
Imatinib mesylate
Surgery
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Bibliografía
[1.]
J.K. Trupiano, R.E. Stewart, C. Misick, H.D. Appelman, J. Goldblum.
Gastric stromal tumors: a clinicopathologic study of 77 cases with correlation of features with nonaggressive and aggressive clinical behaviors.
American J Surg Pathol, 26 (2002), pp. 705-714
[2.]
C.M. De Silva, R. Reid.
Gastrointestinal stromal tumors (GIST): c-kit mutations, CD117 expression, differential diagnosis and targeted cancer theraphy with imatinib.
Pathol Oncol Res, 9 (2003), pp. 13-19
[3.]
R. Dagher, M. Cohen, G. Williams, M. Rothmann, J. Gobburu, G. Robbie, et al.
Approval summary: imatinib mesylate in the treatment of metastatic and/or unresectable malignant gastrointestinal stromal tumors.
Clin Cancer Res, 8 (2002), pp. 3034-3038
[4.]
I. Ray-Coquard, A. Le Cesne, V. Michallet, I. Boukonivas, I. Ranchere, P. Thiesse, et al.
Gastro-intestinal stromal tumors: news and comments.
Bull Cancer, 90 (2003), pp. 69-76
[5.]
H. Yan, P. Marchettini, Y. Acherman, S.A. Gething, E. Brun, P.H. Sugarbaker.
Prognostic assessment of gastrointestinal stromal tumor.
Am J Clin Oncol Cancer Clin Trials, 26 (2003), pp. 221-228
[6.]
R.P. DeMatteo.
The GIST of targeted cancer theraphy: a tumor (gastrointestinal stromal tumor), a mutated gene (c-kit), and a molecular inhibitor (STI571.
Ann Surg Oncol, 9 (2002), pp. 831-839
[7.]
C. Langer, B. Gunawan, P. Schuler, W. Huber, L. Fuzesi, H. Becker.
Prognostic factors influencing surgical management and outcome of gastrointestinal stromal tumors.
Br J Surg, 90 (2003), pp. 332-339
[8.]
J.M. Alamo Martínez, F. López Bernal, A. Galindo Galindo, J.A. Guerra Bautista, J.M. Sousa Vaquero, C. Cruz Villalba, et al.
Pequeño GIST duodenal como causa de hemorragia digestiva en un paciente joven.
Cir Esp, 73 (2003), pp. 262-263
[9.]
Y.R. Choi, H. Kim, H.J. Kang, N.G. Kim, J.J. Kim, K.S. Park, et al.
Overexpression of high mobility group box 1 in gastrointestinal stromal tumors with KIT mutation.
Cancer Res, 63 (2003), pp. 2188-2193
[10.]
I. Gayet, T. Vu, R. Iyer, M. Johnson, H. Macapinlac, N. Swanston, et al.
The role of 18F-FDG PET in staging and early prediction of response to therapy of recurrent gastrointestinal stromal tumors.
J Nucl Med, 45 (2004), pp. 17-21
Copyright © 2004. Elsevier España, S.L.. Todos los derechos reservados
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