Iterative Multimodal Approach In The Treatment Of Abdominal Stromal Tumors

Abstract

Approach in the Treatment of Abdominal Abstract We report two cases of abdominal stromal tumors with prolonged survival after mixed management or multimodal approach combining radical iterative surgery, intraperitoneal chemotherapy and targeted therapy (Imatinib). These two observations illustrate the current possibility of long-term control of abdominal stromal tumors when there are locally advanced and/or metastatic. Carbohydrate antigen (CA125) 45IU Abdominal the existence of large intraperitoneal masses 6 to 8 cm in diameter, which were confirmed by computed tomography. These masses were tissue-like and took on contrast. The chest x-ray was without features. The patient was operated on with the diagnosis of ovarian cancer and the goal of the intervention was an exploratory intervention with possibly a gesture of excision if it was immediately possible. The intraoperative exploration showed the existence of at least 7 tumor masses sitting on the small intestine and each making at least 5cm. The two ovaries were healthy and so was the rest of the peritoneal cavity. The PCI was estimated at 12 points. An extemporaneous examination was in favor of a sarcomatous tumor. Given the extent of the lesions, we preferred to carry out seven resections-anastomoses with restoration of digestive continuity instead of an extensive resection of the small intestine. EPIC was carried out on the patient after the placement of two liters of SSI associated with 8mg of Doxorubicin, from the first to the 5th postoperative day. The follow-up to the intervention was simple and the left the ward on the 14th postoperative day. At twelve months postoperative, the presented a palpable tumor recurrence in the firm left sub-costal area that was not painful. It measured at least 10cm in diameter. Computed tomography showed the presence of this next to the and spleen. The rest of the peritoneal cavity was without abnormalities.