A 57 year old male was diagnosed as a case of gastrointestinal stromal tumor (GIST) 4 years ago and had undergone surgery for the same. The tumor was very large had required the opening up the abdomen (laparotomy) and left chest (thoracotomy). After successful removal of the tumor he received chemotherapy in the form of Imatinib 400 mg once a day orally. He was kept on regular surveillance with PET CT every 6-12 months. No progression of the disease was noted. He discontinued his medication after 3 years despite medical opinion to the contrary. Within one year of stopping treatment he presented to us with pain abdomen and a palpable mass in the upper abdomen. His PET scan was suggestive of extensive recurrent disease. He underwent surgery with removal (debulking) of as much tumor as possible. The histopathology revealed a more aggressive form of the tumor. He is planned restart his chemotherapy based on mutational analysis studies.

Public information: GIST is a common malignancy which has good response to both surgery and chemotherapy. After surgery the patient should be on chemotherapy as prescribed by the physician and requires close follow up as recurrence of disease is known after stopping the treatment.