Transvaginal Resection of a Rectal Gastrointestinal Stromal Tumor: A Case Report

Abstract

Gastrointestinal stromal tumors (GISTs) are a type of mesenchymal tumors. They are rare in rectum. This location is a surgical challenge due to the high morbidity after aggressive surgeries. We present the case of an 81-year-old female with a high-grade GIST treated with transvaginal excision and adjunctive therapy with imatinib. The postoperative period was uneventful without anal dysfunction. Within the types of surgical treatment available, transvaginal excision is an acceptable procedure in lesions located in the rectovaginal region.

Leiomyosarcoma of the rectum: A systematic review of recent literature

“…Various surgical techniques and approaches for local resection of rGISTs have been widely described, including open transanal resection, 92 transanal endoscopic microsurgery (TEM), 93–95 transanal minimally invasive surgery (TAMIS), 96,97 laparoscopic 98,99 transperineal 100,101 presacral 102,103 transacral 104–106 and transvaginal approaches 107–109 …”

“…Various surgical techniques and approaches for local resection of rGISTs have been widely described, including open transanal resection, 92 transanal endoscopic microsurgery (TEM), [93][94][95] transanal minimally invasive surgery (TAMIS), 96,97 laparoscopic 98,99 transperineal 100,101 presacral 102,103 transacral [104][105][106] and transvaginal approaches. [107][108][109] Imatinib therapy appears to be the standard first-line treatment for locally advanced, inoperable, and metastatic patients, and for metastatic patients who have had all lesions surgically removed. 88 All GISTs have the potential to develop metastases and their biological behavior is variable.…”

Recent Advancements in the Treatment of Rectal Gastrointestinal Stromal Tumor: In Era of Imatinib

“…IM, a specific tyrosine kinase receptor inhibitor (TKI), was approved by the US Food and Drug Administration (FDA) as the first-line treatment for advanced GIST in February 2002. 29 IM is also the only TKI currently available for neoadjuvant therapy (nIM), and the standard dose is 400 mg/day. 30 , 31 However, a case report also showed that sunitinib was selected for neoadjuvant therapy for gastrointestinal stromal tumors firstly.…”

“…IM was approved by the FDA as a first-line treatment for advanced GIST in February 2002. 29 Two-phase III trials determined that 400 mg daily was the optimal dose of IM in advanced GIST. In the trials of S0033 and phase III European Cancer Research and Treatment Group 62,005 trials, both trials demonstrated a significant clinical benefit of IM 400mg/ day.…”

“…Based on these data, the standard dose of adjuvant IM is 400mg/ day. 29 , 58 The BFR14 59 trial evaluated patients with advanced GIST whose tumors responded to IM or were in a stable state. At 1, 3, or 5 years after discontinuing IM treatment, patients who stopped treatment had shorter PFS compared to those who continued treatment.…”