The size and number is not everything to evaluate the tumor response in gastrointestinal stromal tumors
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Case report

The size and number is not everything to evaluate the tumor response in gastrointestinal stromal tumors

Acta Haematol Oncol Turc 2018;51(1):110-117 DOI: 10.5505/aot.2018.53244
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Abstract

Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract. Contrast-enhanced computed tomography is the most commonly used for evaluating response to treatment. Targeted therapies may cause some changes in tumor structure. Reduced lesion vascularity, cavitations, and intratumoral hemorrhage are some changes in patients after imatinib therapy, even without any size reduction. Paradoxically, a transient increase in size may be seen in some cases due to cystic change and intratumoral hemorrhage. Alternative tumor response criteria were developed by Choi et al. in gastrointestinal stromal tumor. Choi et al. showed that not only the tumor size but also the tumor density are important in evaluating the response. In this study, we presented a 67-year-old male patient treated with imatinib receiving a gastrointestinal stromal tumor diagnosis. After 3 months of imatinib treatment, liver lesions were reported as progression in response assessment.

Keywords: Gastrointestinal stromal tumor, Imatinib, Choi criteria