Near-infrared fluorescence-guided metastasectomy for hepatic gastrointestinal stromal tumor metastases using indocyanine green : A case report

Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved..

INTRODUCTION AND IMPORTANCE: Gastrointestinal stromal tumors are the most prevalent mesenchymal tumors of the gastrointestinal tract. Distant metastases are most often found in the liver or peritoneum with surgery being the preferred treatment option. In our center, fluorescence-guided surgery with indocyanine green is used as standard-of-care for hepatic metastases in colorectal cancer. This case report describes fluorescence-guided metastasectomy for a hepatic gastrointestinal stromal tumor in two patients undergoing open liver resection and radiofrequency ablation.

CASE PRESENTATION: A 69-year old women was seen during follow-up after laparoscopic resection of a GIST in the lesser curvature of the stomach. Contrast-enhanced computed tomography imaging showed two suspicious lesions in liver segment VI and VIII. Intraoperative near-infrared fluorescence imaging of the liver clearly revealed the lesion in segment VIII, and an additional lesion in segment V - which was not seen on preoperative CT-imaging, neither on intraoperative ultrasonography. The lesion in segment VI was not seen with NIRF imaging due to its deeper location in the liver parenchyma. The second case is an 82-year old man who was also diagnosed with liver metastases from a GIST in the stomach and was scheduled for near-infrared fluorescence-guided liver resection and radio frequency ablation.

CLINICAL DISCUSSION: In this case report we demonstrated the feasibility of fluorescence-guided surgery in detection of liver metastases and treatment planning of two patients with hepatic GIST metastases using indocyanine green.

CONCLUSION: NIRF-imaging with ICG is useful for identification of preoperatively discovered lesions, surgical resection planning and margin evaluation, and for detection of additional hepatic GIST metastases.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:78

Enthalten in:

International journal of surgery case reports - 78(2021) vom: 15. Jan., Seite 250-253

Sprache:

Englisch

Beteiligte Personen:

Bijlstra, O D [VerfasserIn]
Achterberg, F B [VerfasserIn]
Tummers, Q R J G [VerfasserIn]
Mieog, J S D [VerfasserIn]
Hartgrink, H H [VerfasserIn]
Vahrmeijer, A L [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Case report
Gastrointestinal stromal tumor
Indocyanine green
Liver metastases
Near-infrared fluorescence-guided surgery

Anmerkungen:

Date Revised 18.01.2021

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1016/j.ijscr.2020.12.058

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM319253066