RESUMEN
BACKGROUND: Gastro-Intestinal stromal tumours (GISTs) are rare and our understanding of their natural history and optimal treatment are continually evolving. Port site metastasis after laparoscopy for a GIST is an extremely rare phenomenon. CASE PRESENTATION: We report a case with relevant imaging and discuss factors that may have contributed to the development of this isolated metastasis. CONCLUSION: Percutaneous methods of sampling GIST tumours for analysis should be avoided if at all possible. When necessary, prophylactic measures should be utilised to minimise the risk of seeding.
Asunto(s)
Tumores del Estroma Gastrointestinal/patología , Laparoscopía/efectos adversos , Metástasis de la Neoplasia , Siembra Neoplásica , Anciano , Femenino , Tumores del Estroma Gastrointestinal/diagnóstico , Humanos , Tomografía de Emisión de Positrones , Proteínas Proto-Oncogénicas c-kit/análisis , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: The prognosis for patients with liver metastases from colorectal carcinoma is limited because of the low number of patients who are eligible for curative hepatic resection. In this phase I study, 31 liver metastases in 24 patients with nonresectable metastases from colorectal carcinoma were treated with photodynamic therapy (PDT). METHODS: The photosensitizer 5,10,15,20-tetrakis(m-hydroxyphenyl)bacteriochlorin (mTHPBC) was intravenously administered in a dose of .6 mg/kg (n = 12) or .3 mg/kg (n = 12). After 120 hours (n = 18) or 48 hours (n = 6), tumors were illuminated for 300 to 600 seconds through percutaneously inserted optical fibers with a light dose of 60 J/cm of diffuser (740 nm). RESULTS: Tumor necrosis at 1 month after PDT was achieved in all treated lesions. Laser treatment was associated with mild pain (n = 8) and transient subclinical hepatotoxicity (n = 21). In one patient, PDT damage to the pancreas was inflicted, and in another patient, PDT damage of the skin occurred, but no serious clinical complications from PDT were reported. Administration of .6 mg/kg of mTHPBC led to transient phlebitis in 10 patients, and 3 patients experienced mild skin phototoxicity after excess light exposure. CONCLUSIONS: Colorectal liver metastases that are ineligible for resection can be safely and effectively treated with interstitial mTHPBC-based PDT.