Gastrointestinal stromal tumor of the stomach with lymph node metastasis treated by laparoscopic and endoscopic cooperative surgery with lymph node pick-up resection: A case report and literature review

INTRODUCTION: Gastrointestinal stromal tumor of the stomach with lymph node metastasis is a rare condition, and few cases have been treated by gastrectomy and systematic lymph node dissection. PRESENTATION OF CASE: We report the case of a patient who was treated by local resection with laparoscopic and endoscopic cooperative surgery and lymph node pick-up resection. A 73-year-old woman presented with gastric submucosal tumor and swollen lymph node. The submucosal tumor was 30 mm in size. After surgery, the tumor was confirmed to be a gastrointestinal stromal tumor by immunostaining. No recurrence was noted 36 months following the surgery. DISCUSSION: Laparoscopic and endoscopic cooperative surgery allows minimal resection because the exact resection margin can be identified. Therefore, endoscopy is a useful aid in the treatment of gastric gastrointestinal stromal tumor. The MIB-1 index of metastatic lymph node was lower than that of a primary lesion; hence, the prognosis might not depend on lymph node metastasis. CONCLUSION: Laparoscopic and endoscopic cooperative surgery and lymph node pick-up resection were useful and minimally invasive. Systematic lymph node dissection is not a viable option.