An 83-year-old woman was hospitalized with abdominal discomfort. Abdominal computed tomography(CT)revealed a hugetumor (size, 15 cm)in thegastric body. Based on thefindings of endoscopic ultrasonography-guided fine-needle aspiration, she was diagnosed with
gastrointestinal stromal tumor(GIST). Invasion of thesurrounding viscera and distant
metastasis were not observed; however, owing to the
tumor size(>10 cm), we initiated
neoadjuvant chemotherapy with
imatinib. CT performed a month after
chemotherapy revealed
tumor shrinkage, and CT repeated 6 months after the second CT revealed
tumor shrinkage to 8 cm. The patient showed a partial response to
chemotherapy. She was deemed suitable to undergo laparoscopic radical resection and subsequently underwent laparoscopic partial gastric resection. Histopathological examination of the resected specimen(measuring 10 cm)revealed hyaline degeneration in most
tumor cells and positive ckit expression in only some proportion of
tumor cells. Based on histopathological evaluation, the
tumor was diagnosed as Grade 2b. The patient showed an uneventful postoperative course. After discharge, she received
imatinib as
adjuvant chemotherapy and is progressing well without recurrence. Taken together, we reported the case of a huge gastric GIST in a patient who showed significant
tumor shrinkage following preoperative
neoadjuvant chemotherapy and successfully underwent laparoscopic radical resection.