Mohd Abdul Hadi Mohd Anuar, April Camilla Roslani, Nora Abdul Aziz and Mohd Razali Ibrahim
University Malaya Medical Centre, Malaysia
Posters & Accepted Abstracts: J Anesth Clin Res
Gastrointestinal stromal tumor is a rare type of GI malignancy, constituting only 0.1-0.3% in total. However they are the commonest primary mesenchymal neoplasms occurring along the Gl tract, most prevalent in the stomach (60-70%), followed by the small bowel (20-30%) and the least occurrence in oesophagus, mesentery, omentum, large bowel and rectum (<5%). Mutations involving the type III receptor tyrosine kinase KIT (CD117) and Platelet-Derived Growth Factor Alpha (PDGFRA) causing the activation of these oncogenes are the key factor in development of GIST. Diagnoses are made based on tissue biopsy. Immuno-Histochemistry (IHC) staining for CD117 can detect the expression of the KIT receptor protein. Pre-operative planning will include assessment of patient’s fitness for surgery, endoscopy, staging computed tomography and magnetic resonance imaging for lesion involving specific area such as the pelvis. Surgery is the primary treatment for cure or relief of symptoms. In the advances of identification of molecular as well as IHC basis of this disease, with TKI as the adjunct to surgery, management of GIST has seen a paradigm shift towards better disease control, lower recurrence rate and promising curative outcomes. Role of TKI in controlling disease progress for non-resectable disease has also been studied and found to be effective. We present a case of a young gentleman whom had received 12 months of neoadjuvant Imatinib prior to a complete R0 resection of a rare anorectal GIST.
Mohd Abdul Hadi Mohd Anuar is currently pursuing Masters of General Surgery in University of Malaya, Kuala Lumpur. He has completed MBBS degree in University of Malaya in the year 2011 and has been working as Surgical Trainee for 6 years.