Laparoscopic resection for imatinib-resistant recurrent tumors of gastric gastrointestinal stromal tumors: A case report.

An 82-year-old woman underwent laparoscopic partial gastrectomy for fundal gastrointestinal stromal tumor (GIST) in a previous hospital. She visited our hospital for the treatment of recurrence, because two nodules, one each on the gastric suture line and in the peritoneum of the left diaphragm, were pointed out. Imatinib therapy was immediately initiated, and the size of both nodules decreased. However, the one on the gastric suture line showed regrowth after 4 years, which was eventually diagnosed as imatinib-resistant GIST. Hence, laparoscopic partial gastrectomy with peritoneal imatinib-sensitive nodule resection was subsequently performed. Pathologically, the nodule on the gastric suture line was confirmed as a GIST, whereas the other was diagnosed as a hyaline-degenerated GIST. Surgical intervention for imatinib-resistant GISTs has been reported to improve the outcomes of recurrent GISTs. Laparoscopic resection of localized imatinib-resistant GISTs could safely and less invasively be performed in this case; however, caution should be paid to the indication of the approach.