Title: Primary Hepatic GIST with IVC invasion, first case reported

Date: December 2019

Speciality: Surgical Gastroenterology/HPB and Liver Transplant

Location: Apollo Hospital, Lucknow

About the Patient and condition

Mrs chandrawati 54/f was evaluated at apollo hospitals lucknow and diagnosed as extra-gastrointestinal stromal tumor (EGIST) of liver with tumor extension into inferior vena cava (IVC).

Case Scenario

Mrs Chandrawati with ECOG 1, was diagnosed as primary Gastrointestinal stromal tumor (GIST) of liver with invasion into upper part of IVC. Dr Waliullah Siddiqui senior consultant HPB and Surgical Gastroenterology planned the surgery after workup. Intraoperatively as told by dr waliulluah there was tumor extension into the upper part of IVC from the liver mass, making it difficult to separate from liver. IVC was clamped by side biting satinsky clamp, right hepatectomy completed. Tumor was palpable into the IVC. IVC opened for around 8 cm, tumor was seen arising from IVC wall (see pic), tumor with partial IVC wall was excised in length followed by repair of IVC. Postoperative patient had uneventful recovery and discharged on POD 6. His Histopahtology and genetic study was suggestive of GIST with negative margin. Five months post-surgery she is fine and on imatinib.

Worldwide Scenario

Gastrointestinal stromal tumor (GIST) is primarily located in alimentary tract. A small portion of GIST occurring outside alimentary tract is known as Extra-gastrointestinal stromal tumor (EGIST). GIST in liver is mostly commonly metastatic. Primary Gastrointestinal stromal tumor of liver is extremely rare. To date only 9 cases of primary hepatic GIST have been reported, but this is first case report of primary hepatic GIST involving the inferior vena cava.

Expertise at Apollo Hospitals

A complex surgery like this requires a dedicated team of Gastrosurgeon, Anaesthesia, Hepatologist, Pathologist, Medical oncologist, Radiology and ICU. We at Apollomedics lucknow are regularly performing complex Liver, pancreatic and biliary (HPB) surgery. Besides, with laparoscopic cusa we extend the horizon laparoscopic liver surgery which is done in few centres of world.

Apollo Hospitals - Touching Lives

We keep in touch with patients post surgery and are readily available for redressal of any problem in future.

Patient's testimonial

Due to low appetite and severe pain in lower abdomen we went to many hospitals. After not getting proper treatment from many hospitals even in Delhi, we googled best gastro surgeon in Uttar Pradesh and found Dr. Waliullah Siddiqui, We met doctor, he told us everything about situation and suggested a liver surgery. I must quote one thing that on the 2nd day of surgery my wife started taking a normal diet and now she is much better than earlier with no pain. Also now she is gaining weight which she loose while in disease.

We are very happy now and would like to thanks Dr. Waliullah and team Apollomedics Hospitals for their best support and staffs.