Neoadyuvancia Con Imatinib en El Manejo De Gist Gigante Del Tabique Rectovaginal

Abstract

Neo-adjuvant treatment with imatinib for a rectal gastrointestinal stromal tumor Background: Rectal gastrointestinal stromal tumors (GIST) are rare. Neo-adjuvant therapy with imatinib is recommended for locally advanced or non-resectable tumors. Case report: We report a 63 years old woman with a malignant GIST located in the recto-vaginal septum which was initially considered nonresectable. The patient was treated with imatinib as induction therapy for three months. After this lapse the tumor was successfully excised using an endo-anal approach. Due to a tumor size over 5 cm and the presence of 13 mitoses per 50 high power fields, two bad prognostic factors, treatment with imatinib was maintained for 15 months after surgery. After 20 months of follow up, the patient is free of disease with complete fecal continence and with an adequate sexual life. Secondary effects of imatinib are gradually subsiding

Tratamiento neoadyuvante con imatinib de un tumor gigante del estroma gastrointestinal rectal

“…A pesar de los múltiples artículos publicados en la literatura, no existe consenso acerca de la dosis y la duración de la neoadyuvancia con imatinib 8 . Habitualmente, se mantiene durante tres a seis meses, con controles radiológicos periódicos 9 . En lo que sí parece haber consenso es sobre la mayor eficacia quirúrgica después de 6 a 12 meses de haber iniciado el tratamiento con imatinib 10 , ya que ha demostrado aumentar la supervivencia libre de enfermedad en los pacientes con GIST rectal 4 .…”