Management of metastatic gastrointestinal stromal tumor by multiple surgical interventions including pancreatoduodenectomy, liver resection and two liver transplants: Worth the effort?

Background: Gastrointestinal stromal tumor (GIST) is a rare malignant disease which originates from the pacemaker cells of the gastrointestinal tract and in the case of metastatic spread usually has a poor prognosis. Methods: We report a case of a woman who underwent multiple surgical procedures including a pancreatic resection and two liver transplants and in addition received Gleevec, somatostatin and the new experimental compound Sunitinib. Results: With this intensive approach she survived more than 12 years after being first diagnosed with GIST. Conclusions: In selected cases patients with metastatic GIST may benefit from such an aggressive approach.