Huge esophageal gastrointestinal stromal tumor successfully resected under mediastino-laparoscopic transhiatal esophagectomy: a case report
Abstract Background Esophageal gastrointestinal stromal tumors (E-GISTs) are often diagnosed early due to complaints such as dysphagia and are rarely found to be huge in size. Here, we report the treatment of a case of huge E-GIST successfully resected by minimally invasive surgery after neoadjuvant...
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Japan Surgical Society
2022-06-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-022-01464-z |
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| author | Keisuke Mishima Takeshi Matsutani Ryo Yamagiwa Hidetsugu Hanawa Yuji Kurihara Norio Motoda Nobuhiko Taniai Hiroshi Yoshida |
| author_facet | Keisuke Mishima Takeshi Matsutani Ryo Yamagiwa Hidetsugu Hanawa Yuji Kurihara Norio Motoda Nobuhiko Taniai Hiroshi Yoshida |
| author_sort | Keisuke Mishima |
| collection | DOAJ |
| description | Abstract Background Esophageal gastrointestinal stromal tumors (E-GISTs) are often diagnosed early due to complaints such as dysphagia and are rarely found to be huge in size. Here, we report the treatment of a case of huge E-GIST successfully resected by minimally invasive surgery after neoadjuvant imatinib therapy. Case presentation An 86-year-old male patient with a 3-month history of dysphagia was referred to our hospital because of a suspected mediastinal tumor on chest X-ray. The chest computed tomography scan revealed a huge solid tumor, of about 100 mm in diameter, protruding into the left thoracic cavity. Histopathological examination results of fine-needle aspiration biopsy under endoscopic ultrasonography revealed a c-kit and CD34-positive esophageal gastrointestinal stromal tumor. The patient received neoadjuvant therapy with imatinib (400 mg/day) to reduce the size of the tumor and prevent rupture during resection. After 28 days of oral administration of imatinib, the tumor size decreased. However, the patient refused to continue treatment with imatinib and therefore underwent mediastino-laparoscopic transhiatal esophagectomy. We successfully resected the tumor completely with mediastino-laparoscopic surgical techniques. Esophageal reconstruction was performed using a gastric tube in the posterior sternal route. After an uneventful postoperative course, the patient was discharged postoperative day 14. Immunohistochemical findings of the resected specimen showed that the tumor cells were positive for c-kit, DOG-1 and CD34 and negative for smooth muscle actin and S100. Conclusions Hybrid surgical procedure utilizing mediastino-laparoscopy might be useful for high-risk patient with esophageal tumors. |
| format | Article |
| id | doaj-art-b42820d8c97c43bcbef2544782e54971 |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-b42820d8c97c43bcbef2544782e549712025-08-20T03:35:57ZengJapan Surgical SocietySurgical Case Reports2198-77932022-06-01811610.1186/s40792-022-01464-zHuge esophageal gastrointestinal stromal tumor successfully resected under mediastino-laparoscopic transhiatal esophagectomy: a case reportKeisuke Mishima0Takeshi Matsutani1Ryo Yamagiwa2Hidetsugu Hanawa3Yuji Kurihara4Norio Motoda5Nobuhiko Taniai6Hiroshi Yoshida7Department of Digestive Surgery, Nippon Medical School Musashikosugi HospitalDepartment of Digestive Surgery, Nippon Medical School Musashikosugi HospitalDepartment of Digestive Surgery, Nippon Medical School Musashikosugi HospitalDepartment of Digestive Surgery, Nippon Medical School Musashikosugi HospitalDepartment of Digestive Surgery, Nippon Medical School Musashikosugi HospitalDepartment of Diagnostic Pathology, Nippon Medical School Musashikosugi HospitalDepartment of Digestive Surgery, Nippon Medical School Musashikosugi HospitalDepartment of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School HospitalAbstract Background Esophageal gastrointestinal stromal tumors (E-GISTs) are often diagnosed early due to complaints such as dysphagia and are rarely found to be huge in size. Here, we report the treatment of a case of huge E-GIST successfully resected by minimally invasive surgery after neoadjuvant imatinib therapy. Case presentation An 86-year-old male patient with a 3-month history of dysphagia was referred to our hospital because of a suspected mediastinal tumor on chest X-ray. The chest computed tomography scan revealed a huge solid tumor, of about 100 mm in diameter, protruding into the left thoracic cavity. Histopathological examination results of fine-needle aspiration biopsy under endoscopic ultrasonography revealed a c-kit and CD34-positive esophageal gastrointestinal stromal tumor. The patient received neoadjuvant therapy with imatinib (400 mg/day) to reduce the size of the tumor and prevent rupture during resection. After 28 days of oral administration of imatinib, the tumor size decreased. However, the patient refused to continue treatment with imatinib and therefore underwent mediastino-laparoscopic transhiatal esophagectomy. We successfully resected the tumor completely with mediastino-laparoscopic surgical techniques. Esophageal reconstruction was performed using a gastric tube in the posterior sternal route. After an uneventful postoperative course, the patient was discharged postoperative day 14. Immunohistochemical findings of the resected specimen showed that the tumor cells were positive for c-kit, DOG-1 and CD34 and negative for smooth muscle actin and S100. Conclusions Hybrid surgical procedure utilizing mediastino-laparoscopy might be useful for high-risk patient with esophageal tumors.https://doi.org/10.1186/s40792-022-01464-zEsophageal gastrointestinal stromal tumorMediastino-laparoscopic surgeryNeoadjuvant therapy with imatinib |
| spellingShingle | Keisuke Mishima Takeshi Matsutani Ryo Yamagiwa Hidetsugu Hanawa Yuji Kurihara Norio Motoda Nobuhiko Taniai Hiroshi Yoshida Huge esophageal gastrointestinal stromal tumor successfully resected under mediastino-laparoscopic transhiatal esophagectomy: a case report Surgical Case Reports Esophageal gastrointestinal stromal tumor Mediastino-laparoscopic surgery Neoadjuvant therapy with imatinib |
| title | Huge esophageal gastrointestinal stromal tumor successfully resected under mediastino-laparoscopic transhiatal esophagectomy: a case report |
| title_full | Huge esophageal gastrointestinal stromal tumor successfully resected under mediastino-laparoscopic transhiatal esophagectomy: a case report |
| title_fullStr | Huge esophageal gastrointestinal stromal tumor successfully resected under mediastino-laparoscopic transhiatal esophagectomy: a case report |
| title_full_unstemmed | Huge esophageal gastrointestinal stromal tumor successfully resected under mediastino-laparoscopic transhiatal esophagectomy: a case report |
| title_short | Huge esophageal gastrointestinal stromal tumor successfully resected under mediastino-laparoscopic transhiatal esophagectomy: a case report |
| title_sort | huge esophageal gastrointestinal stromal tumor successfully resected under mediastino laparoscopic transhiatal esophagectomy a case report |
| topic | Esophageal gastrointestinal stromal tumor Mediastino-laparoscopic surgery Neoadjuvant therapy with imatinib |
| url | https://doi.org/10.1186/s40792-022-01464-z |
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