A CASE OF GASTROINTESTINAL STROMAL TUMOR OF THE SMALL INTESTINE WITH A LONG-TERM SURVIVAL AFTER THE FOURTH RESECTION UNDER EXTRACORPOREAL CIRCURATION

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Gastrointestinal stromal tumor (GIST) of the small intestine is a relatively rare entity. We report a case of GIST of the small intestine with a long-term survival resulting from four operations.A 57-year-old woman was pointed out having a jejunal tumor during surgery for an ovarian tumor at the department of gynecology in our hospital, and underwent a partial excision of the jejunum. Histopathological diagnosis was GIST. Eight and eleven years after the operation, the patient underwent a hepatectomy due to liver metastasis. Thirteen years after the operation, she was found to have an enlarging metastasis in the liver remnant and retroperitoneal metastasis with invasion into the inferior vene cava. She underwent a hepatectomy with associated excision of the inferior vena cava, which resulted in favorable outcome.GISTs are apt to metastasize to relatively localized areas, and grow gradually and expansively. Deterioration of the patient's general condition is believed to progress slowly. From these standpoints, we would have to excise GIST as possible with the expectation of long-term survival of the patient, even though extracorporeal circulation is required.
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