Management of low rectal gastrointestinal stromal tumor with neoadjuvant therapy and transanal excision: a rare case report and review of the literature

Abstract

Christopher Kosmidis,1,2 Konstantinos Sapalidis,1 Alexandros Tsakalidis,1 Stefanos Atmatzidis,1 Nikolaos Michalopoulos,1 Georgios Koimtzis,1 Georgia Karayannopoulou,3 Sofia Lypiridou,3 Nikolaos Varsamis,2 Georgios Kouklakis,2 Sofia Baka,2 Paul Zarogoulidis,1 Isaac Kesisoglou1 1Third Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2Department of Oncology, Interbalkan Medical Center, Thessaloniki, Greece; 3Department of Pathology, Aristotle University of Thessaloniki, Thessaloniki, Greece Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. However, rectal GISTs represent only 5% of this category. We report a case of a rectal GIST treated with local excision after neoadjuvant therapy. Case presentation: A 41-year-old male patient presented with anal bleeding. Colonoscopy revealed a mass located 5 cm from the anal verge. Histological examination showed a GIST with immunohistochemical positivity for CD117 and CD34. Transanal local excision was performed after neoadjuvant therapy. Conclusion: Neoadjuvant immunotherapy for GISTs with unfavorable localization may facilitate local excision and avoid complications of more demanding operations. Keywords: gastrointestinal stromal tumor, rectal, neoadjuvant therapy, transanal excision

Keywords

• Gastrointestinal stromal tumor
• Rectal
• Neoadjuvant Therapy
• Transanal Excision