Gastrointestinal stromal tumor surgery in pediatrics.
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INTRODUCTION: Gastrointestinal stromal tumors (GIST) are infrequent in pediatric patients. The management of metastatic and irresectable tumors is usually non-surgical, with tyrosine-kinase inhibitors being the treatment of choice. CLINICAL CASE: We present the case of a 14-year-old female patient with a metastatic and irresectable GIST treated with sunitinib that required surgery as a result of severe hemoperitoneum episodes with anemia and hemodynamic instability. A cytoreductive surgery with R2 resection margins was carried out. After a 10-year follow-up period, the patient remains under oncological treatment. DISCUSSION: The treatment of metastatic and irresectable GIST consists of tyrosine-kinase inhibitors. Evidence regarding the role of surgery remains limited, which means extreme caution should be exerted when indicating surgical treatment. However, surgery is still a useful tool within the array of therapeutic options.