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First report of a complete pathological response of a pelvic GIST treated with imatinib as neoadjuvant therapy
  1. M Salazar1,
  2. A Barata2,
  3. S André3,
  4. J Venâncio4,
  5. I Francisco5,
  6. M Cravo6,
  7. C Nobre-Leitão6
  1. 1Department of Gastroenterology, Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal
  2. 2Department of Surgery, Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal
  3. 3Department of Pathology, Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal
  4. 4Department of Radiology, Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal
  5. 5Department of Molecular Biology, Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal
  6. 6Departments of Gastroenterology and Molecular Biology, Instituto Português de Oncologia Francisco Gentil, Lisbon, Portugal
  1. Correspondence to:
    Dr M Salazar
    Serviço de Gastreterologia, IPOFG-CROL, SA, R. Prof Lima Basto, 1099-023 Lisboa, Portugal; msalazar{at}netcabo.pt

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Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract, with approximately 5% being located at the rectum. Up to two thirds of GISTs may have a malignant behaviour, with a high recurrence rate.1

We report a case of a 68 year old woman with multiple local recurrences of a rectal GIST, first operated on 13 years earlier, and who now presented with four adjacent masses located in the rectovaginal septum and no distant metastasis. Molecular analysis identified a 6 bp deletion in exon 11 of the c-kit proto-oncogene. As curative surgery would have implied abdominoperineal resection with permanent colostomy, treatment with imatinib at a standard dose (400 mg/day) was started. Response to treatment was evaluated using endorectal ultrasound and magnetic resonance imaging every three months. Quantification of tumour mass was obtained by adding the products of …

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