• PDF / 170,239 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 115 Downloads / 175 Views

DOWNLOAD

REPORT

---

1 S

Lack of efficacy and gastrointestinal bleeding: case report A 52-year-old man exhibited lack of efficacy following treatment with imatinib and sunitinib for recurrent gastrointestinal stromal tumour (GIST). Subsequently, he developed gastrointestinal bleeding following treatment with regorafenib for recurrent GIST [not all routes and dosages stated]. The man presented with worsening diffuse abdominal pain, weakness and fatigue which he had been experiencing since one week. His medical history was significant for gastric GIST which had been diagnosed and resected two years prior through partial gastrectomy, distal pancreatectomy and splenectomy. Upon current presentation, he also reported nausea. Flatus and bowel movements were observed. Recurrence of GIST was suspected. He was hospitalised. He had been receiving imatinib [Gleevec] 800 mg/day. However, there was no response. Therefore, the man’s therapy was switched to sunitinib. However, his disease continued to progress. CT of the abdomen and pelvis revealed severe metastatic disease with carcinomatosis and ileus versus early/partial small bowel obstruction. He was treated with unspecified antiemetics and a nasogastric tube. His obstructive symptoms continued to worsen. Seventeen days after admission, he was scheduled for a surgical intervention. The surgery was performed with a primary focus of tumour debulking, bowel decompression and pain alleviation. Within six days of surgery, his pain overall decreased and could be better managed with unspecified pain medications. He experienced episodes of nausea, but not vomiting. He was discharged on postoperative day 17 on oral regorafenib 80mg daily therapy. Six weeks after initiation of regorafenib, he developed gastrointestinal bleeding. The gastrointestinal bleeding was considered to have developed secondary to shrinking of GIST due to regorafenib therapy. The man’s regorafenib was temporarily discontinued. Nine days after the bleeding event, regorafenib was safely resumed with improvement. Ghantarchyan H, et al. Decreasing the burden: An unusual GIST presentation, a case report. International Journal of Surgery Case Reports 74: 243-246, 2020. Available from: 803507098 URL: http://doi.org/10.1016/j.ijscr.2020.08.039

0114-9954/20/1826-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

Reactions 17 Oct 2020 No. 1826