A Case of Liver Metastasis 9 Years after Resection of Gastrointestinal Stromal Tumor of the Duodenum

A 65-year-old man underwent a partial duodenectomy for a 35 mm gastrointestinal stromal tumor (GIST) located in the third portion of the duodenum in August, 2000 and was followed up with no adjuvant therapy. A liver mass was detected by abdominal CT in June, 2009 and he was referred to our hospital...

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Published inThe Japanese Journal of Gastroenterological Surgery Vol. 44; no. 7; pp. 842 - 847
Main Authors Takahashi, Hidenori, Ohue, Masayuki, Yamada, Terumasa, Fukuda, Shuichi, Yamamoto, Masayuki, Yano, Masahiko, Miyashiro, Isao, Ishikawa, Osamu, Gotoh, Kunihito, Ohigashi, Hiroaki
Format Journal Article
LanguageJapanese
Published The Japanese Society of Gastroenterological Surgery 2011
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ISSN0386-9768
1348-9372
DOI10.5833/jjgs.44.842

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Abstract A 65-year-old man underwent a partial duodenectomy for a 35 mm gastrointestinal stromal tumor (GIST) located in the third portion of the duodenum in August, 2000 and was followed up with no adjuvant therapy. A liver mass was detected by abdominal CT in June, 2009 and he was referred to our hospital for examination and treatment. Though disease-free survival was as long as 9 years, a biopsy of the liver mass strongly suggested liver metastasis from the GIST of the duodenum. The specimen was composed of spindle cells positive for c-kit immunohistologically, and GIST was diagnosed. Because the mass was solitary and the liver function was good, we judged that there was an indication for operation, and performed a right hepatectomy. In this case, asymptomatic liver metastasis was detected by the imaging diagnosis, so it is suggested that long-term follow-up including diagnostic imaging is needed for patients with GIST of the duodenum even 5 years or more after the operation.
AbstractList A 65-year-old man underwent a partial duodenectomy for a 35 mm gastrointestinal stromal tumor (GIST) located in the third portion of the duodenum in August, 2000 and was followed up with no adjuvant therapy. A liver mass was detected by abdominal CT in June, 2009 and he was referred to our hospital for examination and treatment. Though disease-free survival was as long as 9 years, a biopsy of the liver mass strongly suggested liver metastasis from the GIST of the duodenum. The specimen was composed of spindle cells positive for c-kit immunohistologically, and GIST was diagnosed. Because the mass was solitary and the liver function was good, we judged that there was an indication for operation, and performed a right hepatectomy. In this case, asymptomatic liver metastasis was detected by the imaging diagnosis, so it is suggested that long-term follow-up including diagnostic imaging is needed for patients with GIST of the duodenum even 5 years or more after the operation.
Author Ohigashi, Hiroaki
Ohue, Masayuki
Yamamoto, Masayuki
Fukuda, Shuichi
Ishikawa, Osamu
Gotoh, Kunihito
Miyashiro, Isao
Yamada, Terumasa
Takahashi, Hidenori
Yano, Masahiko
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  fullname: Takahashi, Hidenori
  organization: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
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  fullname: Ohue, Masayuki
  organization: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
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  fullname: Yamada, Terumasa
  organization: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
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  fullname: Fukuda, Shuichi
  organization: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
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  fullname: Yamamoto, Masayuki
  organization: Department of Surgery, Itami City Hospital
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  fullname: Yano, Masahiko
  organization: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
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  fullname: Miyashiro, Isao
  organization: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
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  fullname: Ishikawa, Osamu
  organization: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
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  fullname: Gotoh, Kunihito
  organization: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
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  fullname: Ohigashi, Hiroaki
  organization: Department of Gastroenterological Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
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References_xml – reference: 6) 熊田まどか,佐藤芳之,羽原 隆,中村昭子,森下慎二,松本政雄,ほか.術後25年目に肝転移が認められた十二指腸原発gastrointestinal stromal tumor(GIST)の1例.日本内科学会関東地方会.2002;502回:27.
– reference: 9) 成清道博,高 済峯,向川智英,青松幸雄,桑田博文,中島洋介.十二指腸原発GIST術後7年目に発見された肝転移切除の1例.日本臨床外科学会雑誌.2004;65(1):93-7.
– reference: 11) 堅野国幸,岩本明美,大上佳三,西江 浩,広岡保明.十二指腸原発GIST術後6年目に多発性肝転移をきたした一例.日本臨床細胞学会雑誌.2005;44:223.
– reference: 1) 伊藤裕美,加藤俊幸,本山展隆,秋山修宏,佐々木俊哉,船越和博,ほか.十二指腸GISTの4例.ENDOSCOPIC FORUM for digestive disease.2007;23(1):37-42.
– reference: 8) 林 寛子,加藤景三,森田敬一,黒岩正憲,長谷川央,林 隆男,ほか.術後6年で多発性肝転移を来した十二指腸GISTの一例.日本消化器病学会雑誌.2004;101:A727.
– reference: 7) 山家 仁,伊藤俊哉,北岡文生,石津 要,青木浩一,大谷 博.十二指腸gastrointestinal stromal tumor の切除後6年間に結腸間膜,肝に転移した1例.日本消化器外科学会雑誌.2003;36(6):476-81.
– reference: 4) 日本癌治療学会,日本胃癌学会,GIST研究会編.GIST診療ガイドライン.東京:金原出版;2008.
– reference: 3) 杉原重哲,鶴田 豊,外山栄一郎,田中睦郎,瀬戸口美保子.肝転移を伴った十二指腸原発gastrointestinal stromal tumorの1切除例.日本消化器外科学会雑誌.2005;38(10):1561-6.
– reference: 10) 渡辺真実,飯合恒夫,黒崎 功,横山直行,神田度夫,畠山勝義.原発巣切除8年後に肝転移をきたした十二指腸GISTの1例.日本臨床外科学会雑誌.2004;65(2):400-3.
– reference: 5) 松下典正,三神俊史,山本清孝,矢崎 浩,小林規俊,太田岳洋,ほか.術後6年目に肝転移を認めた十二指腸gastrointestinal stromal tumor(GIST)の一例.東京女子医科大学雑誌.2002;72(3~4):143.
– reference: 2) Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006 May;23(2):70-83.
– reference: 12) 橋爪健太郎,西浦三郎,井久保丹.肝・腹膜・肺再発に対し4回の切除術を行い19年生存中の十二指腸原発GISTの1例.日本臨床外科学会雑誌.2007;68(2):345-50.
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Snippet A 65-year-old man underwent a partial duodenectomy for a 35 mm gastrointestinal stromal tumor (GIST) located in the third portion of the duodenum in August,...
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SubjectTerms duodenum
gastrointestinal stromal tumor
liver metastasis
Title A Case of Liver Metastasis 9 Years after Resection of Gastrointestinal Stromal Tumor of the Duodenum
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