Multivisceral Resection by Abdominal-Perineal Approach of a Recurrent Extra-Gastrointestinal Stromal Tumor: A Case Report

Simone M, Barile G, Cartanese C, Grasso E, Lomonaco R, Rucci A, Ruggieri E, Albano A, Ammerata G, Cormio G, Ressa C and De Luca R

Department of Surgical Oncology- I.R.C.C.S Istituto Tumori ”Giovanni Paolo II” Bari, Italy
Clinical Trial Center, I.R.C.C.S Istituto Tumori ”Giovanni Paolo II” Bari, Italy
Science of Health Department, Digestive Surgery Unit, “Mater Domini” Hospital, University Magna Grecia Medical School, Italy
Department of Biomedical Sciences and Human Oncology-Section, University of Bari Aldo Moro, Italy
Plastic and Reconstructive Surgery Unit, I.R.C.C.S Istituto Tumori ”Giovanni Paolo II” Bari, Italy

^*Correspondance to: Graziana Barile 

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Abstract:

Gastrointestinal Stromal Tumors (GIST) are a rare heterogeneous group of non-epithelial neoplasms which originate from gastrointestinal mesenchymal tissue. Very rarely, these tumors arise from extraintestinal site. In these cases they are defined as Extragastrointestinal Stromal Tumors’ (EGISTs). The most common sites are the omentum, the mesentery and the etroperitoneum.
EGISTs represent 1% of all GIST.
We report a rare case of a recurrent EGIST of the Rectovaginal Septum (RVS) considering that identification, incidence, tumor behavior, and surgical treatment is still debated.
In July 2004 a 43-year-old woman underwent local excision for EGIST of RVS in another hospital. Adjuvant Treatment (AT) with Imatinib and a follow-up every 4 months was scheduled. In February 2011 Local Recurrence (LR) occurred. Low anterior resection of the rectum extended to the lesion was undergone. Imatinib was resumed with closed follow-up. In April 2017 a second LR of the
vaginal canal occurred. A new pharmacological trial based on Sunitinib and Masitinib was started. In June 2018 by CT scan and pelvic-MRI, a third LR closed with the neo-rectum and the vagina’s distal portion was identified. Clinically the patient presented a voluminous and painful mass of the perineal region and Rectovaginal Fistula (RF) with loss of stool. By the Multidisciplinary Team
(MDT) meetings debulking surgery was planned and performed through a multivisceral resection of the LR by three Surgical Teams (ST) with a combined abdominal-perineal approach. MDT and specialized ST are mandatory in the management of these rare tumors that must be provided in cancer center.

Keywords:

Extragastrointestinal gist; Multidisciplinary team; Multivisceral resection; Imatinib

Cite the Article:

Simone M, Barile G, Cartanese C, Grasso E, Lomonaco R, Rucci A, et al. Multivisceral Resection by Abdominal-Perineal Approach of a Recurrent Extra-Gastrointestinal Stromal Tumor: A Case Report. Clin Oncol. 2022;7:1896..