RESUMO
The management of gastrointestinal stromal tumors, usually defined as c-KIT-positive mesenchymal neoplasias, has evolved very rapidly in the last five years. Imatinib mesylate (Glivec(R)) is the standard treatment in unresectable or metastatic gastrointestinal stromal tumors. Imatinib should be given until development of intolerance or progressive disease. It is not uncommon for gastrointestinal stromal tumors to become larger during the early post-treatment phase and conventional response to treatment criteria in solid tumors have a limited value for evaluation the efficiency of imatinib in this period. FDG-PET has proven to be highly sensitive in detecting early response tumor. A 53-year old woman was diagnosed of relapsed gastrointestinal stromal tumor 18 months after adyuvant imatinib mesylate finished. Imatinib was started and 72 hours later the tumor showed a decrease of fluorodeoxyglucose F18 uptake on positron emission tomography scan.
Assuntos
Antineoplásicos/uso terapêutico , Fluordesoxiglucose F18 , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/secundário , Neoplasias Pélvicas/diagnóstico por imagem , Neoplasias Peritoneais/diagnóstico por imagem , Neoplasias Peritoneais/secundário , Piperazinas/uso terapêutico , Tomografia por Emissão de Pósitrons , Pirimidinas/uso terapêutico , Compostos Radiofarmacêuticos , Antineoplásicos/farmacocinética , Benzamidas , Terapia Combinada , Progressão da Doença , Feminino , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Mesilato de Imatinib , Pessoa de Meia-Idade , Cuidados Paliativos , Neoplasias Pélvicas/tratamento farmacológico , Neoplasias Pélvicas/cirurgia , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/cirurgia , Piperazinas/farmacocinética , Pirimidinas/farmacocinéticaRESUMO
El manejo de los tumores del estroma gastrointestinal, definidos como neoplasias mesenquimales c-Kit positivas, ha cambiado rápidamente en los últimos cinco años. El mesilato de imatinib (Glivec®) es el tratamiento estándar de los tumores del estroma gastrointestinal irresecables o metastáticos. El imatinib debe administrarse hasta el desarrollo de intolerancia o la progresión de la enfermedad. No es infrecuente que los tumores del estroma gastrointestinal aumenten de tamaño durante los primeros meses de tratamiento, de ahí el valor limitado de los criterios convencionales de evaluación de respuesta de los tumores sólidos para determinar la eficacia del imatinib durante este período. La tomografía de emisión de positrones empleando 18F-fluorodesoxiglucosa ha demostrado tener una alta sensibilidad en la evaluación precoz de la respuesta tumoral al imatinib. Presentamos el caso de una mujer de 53 años diagnosticada de recidiva de tumor del estroma gastrointestinal 18 meses después de finalizar tratamiento adyuvante con imatinib. Tras 72 horas de tratamiento con imatinib el tumor mostraba en la tomografía de emisión de positrones una disminución en la captación de 18F-fluorodesoxiglucosa
The management of gastrointestinal stromal tumors, usually defined as c-KIT-positive mesenchimal neoplasias, has evolved very rapidly in the last five years. Imatinib mesylate (Glivec®) is the standard treatment in unresectable or metastatic gastrointestinal stromal tumors. Imatinib should be given until development of intolerance or progressive disease. It is not uncommon for gastrointestinal stromal tumors to become larger during the early post-treatment phase and conventional response to treatment criteria in solid tumors have a limited value for evaluation the efficiency of imatinib in this period. FDG-PET has proven to be highly sensitive in detecting early response tumor. A 53-year old woman was diagnosed of relapse gastrointestinal stromal tumor 18 months after adyuvant imatinib mesylate finished. Imatinib was started and 72 hours later the tumor showed a decrease of fluorodeoxyglucose F18 uptake on positron emission tomography scan