The gastrointestinal stromal tumor (GIST) is a digestive neoplasm of mesenchymal lineage. The treatment strategy for receptor tyrosine kinase-mutated GISTs is well defined. Wild-type GISTs (WT-GISTs) respond unsatisfactorily to specific kinase inhibitors. Moreover, evidence shows that repeat surgery has limited benefit. We report the case of a young female patient who was diagnosed with liver metastatic WT-GIST, after initial radical resection and adjuvant therapy with molecular targeted drugs. Due to the disease progression, a two-stage surgery was performed, with the removal of extrahepatic lesions followed by a total hepatectomy. The patient is disease-free after four years from liver transplantation (LT), performed under everolimus-based immunosuppression. The treatment of WT-GISTs remains a significant challenge due to the frequent resistance to tyrosine kinase inhibitors (TKIs). Liver transplantation might represent an effective treatment option for such disease.
Liver transplantation for metastatic wild-type gastrointestinal stromal tumor in the era of molecular targeted therapies: report of a first case / Iesari, S; Mocchegiani, F; Nicolini, D; Benedetti Cacciaguerra, A; Coletta, M; Montalti, R; Mandolesi, A; Lerut, J; Vivarelli, M.. - In: AMERICAN JOURNAL OF TRANSPLANTATION. - ISSN 1600-6135. - ELETTRONICO. - (2019). [10.1111/ajt.15377]