Background
The use of imatinib mesylate is associated with a progression free survival of 41
months in first line treatment of metastatic or locally advanced gastrointestinal stromal tumors (GIST) and other studies approved that adjuvant imatinib treatment improves the recurrence-free survival in patients with GIST. Current recommendations include 1
year adjuvant treatment in GIST patients at risk but active studies explore different durations of treatment with an interval of up to 5
years. While the most frequent adverse events (AEs) are blood count alterations, abdominal discomfort and edema, the occurrence of grade 3 or 4 increase of AST or ALT is specified with 2.1% and 2.7% respectively.
months in first line treatment of metastatic or locally advanced gastrointestinal stromal tumors (GIST) and other studies approved that adjuvant imatinib treatment improves the recurrence-free survival in patients with GIST. Current recommendations include 1
year adjuvant treatment in GIST patients at risk but active studies explore different durations of treatment with an interval of up to 5
years. While the most frequent adverse events (AEs) are blood count alterations, abdominal discomfort and edema, the occurrence of grade 3 or 4 increase of AST or ALT is specified with 2.1% and 2.7% respectively.Case presentation
We report a 49-year old male with a gastrointestinal stromal tumor (GIST) of the small bowel who developed liver cirrhosis under adjuvant imatinib treatment.
Conclusions
Our report supports the notion that imatinib-induced hepatotoxicity may lead to acute liver damage with subsequent cirrhotic remodelling. Patients developing grade 3 or 4 hepatotoxicity during imatinib treatment should therefore be carefully evaluated for chronic liver disease.
Keywords: GIST, Imatinib, Liver cirrhosis



1 Martin Fenner,1 Florian Länger,3 Heike Bantel,2 Arnold Ganser,1 and Viktor Grünwald1