A 41 yrs old man with a mass(2*2 cm) from 4cm from anal verge. biopsy showed GIST.metastatic work up was negative. EUS confirmed sphincter involvement.
which option do you recommend?
Leonardo Bustamante-Lopez
Neoadjuvant Imatinib followed by transanal endoscopic microsurgery
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Habibollah Mahmoodzadeh
Dear Dr Christos
According to EUS, sphincter was involved by tumor, so LAR is not safe.
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Habibollah Mahmoodzadeh
Dear Colleagues
Minimal surgery like TEM is not oncologically safe and just
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Ladislaus L. Torday
Surgery first, and it seems to be that to ensure radicality, a rectal exstirpation has to be performed. Than, depending on the risk category of the disease, subseqent oncological treatment with imatinib.
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I. V. Kazakov
Considering the size of the tumor surgery first, but surgery should be transanal submucosal resection tumor.
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