Two Decades of Gastrointestinal Stromal Tumor Management With First-Line Treatment: A Case Report.

Gastrointestinal stromal tumors (GISTs) are rare malignant tumors that arise from the connective tissues of the gastrointestinal tract. Reports about GISTs treated with imatinib for over five years are exceedingly rare. In this case report, we present a patient with GIST who remained alive for two decades after undergoing imatinib treatment. We describe a man in his forties with no significant prior medical issues, who presented in 2004 to the emergency department with severe abdominal pain. A computed tomography scan revealed a ruptured intra-abdominal mass. He underwent surgical resection, leading to the diagnosis of jejunal GIST. Following this, he underwent active surveillance until 2007, when the disease recurred. After completing a two-year course of imatinib, no signs of disease were detected, and medical therapy was stopped. However, in 2011, a pelvic recurrence was observed, leading to the re-introduction of imatinib therapy, which was maintained until 2018. A year later, disease progression was noted, prompting the re-initiation of imatinib. Since then, the patient was receiving imatinib therapy with good tolerance, until March of 2024. This case highlights the potential sensitivity of imatinib for a long duration.