Erkan N.Çoker A.Postaci H.Cengiz YilmazElif SelekErdem Goker2019-10-262019-10-2620111108-50021108-5002https://hdl.handle.net/11454/19159Background: Primary pancreatic gastrointestinal stromal tumors are very rare. Here in we present a malignat extragastrointestinal tumor of the pancreas that was managed multi-disciplinarily. Case presentation: A 64 -year -old male patient presented with a several month history of progressive fatique, nausea, loss of appetite and weight loss. Physical examination revealed a large, painless and smoooth epigastric mass. Laboratory data including tumour markers were within normal limits except a mild anemia. An abdominal CT scan revealed a predominantly cystic mass with solid component that had a 22x14 cm in size originating from body of the pancreas. The patient underwent laparotomy and distal pancreatectomy, splenectomy and wedge resection over gastric wall was made. Pathology revealed a malignant extragastrointestinal tumor of the pancreas. During follow-up period of two years, metastases located on 6-7th segment of liver was detected. Patient was treated as adjuvant by imatinib mesylate. Eventhuogh that adjuvant treatment, liver metastases showed progression. Five years after the first initial diagnosis, patient was reoperated for metastatectomy and bisegmentectomy, cholecystectomy and Roux en Y hepaticojejenostomy was made Postoperative period was uneventful and adjuvant imatinib mesylate treatment (400 mg bid) was continued. During follow-up period of 34 months following second surgery, multiple hepatic metasteses were detected and he was death due to multiple organ failure 8 years after initial diagnosis. Conclusion: Although rare in the pancreas, GIST should be considered in differential diagnosis of pancreatic masses and GIST patients with liver metastases require combined multimodal management from the outset.eninfo:eu-repo/semantics/closedAccessExtra-gastrointestinalPancreasStromal tumorArticle164237239Q4