Haiyang ZHOU, Yilei LIU, Peng ZHANG
Journal of Urological Surgery - 2026;13(3):255-258
A 67-year-old female presented to our hospital with a 12-month history of abdominal pain. Preoperative pelvic magnetic resonance imaging revealed a large pelvic mass arising from the anterior wall of the rectum invading the bladder and uterus, with suspected lymph node metastases. To eradicate the tumor, total pelvic exenteration was carried out. An end-to-end colorectal anastomosis was performed. A Y-shaped uretero-ureteral anastomosis coupled with ureterovesical reimplantation was used for urinary reconstruction. Pathology showed the lesion was a high-risk gastrointestinal stromal tumor (GIST). The patient was treated with imatinib for 6 months following the operation, without tumor recurrence. In conclusion, total pelvic exenteration for huge rectal GISTs with concurrent urinary and intestinal reconstruction is technically feasible. However, whenever a preoperative biopsy and pathological diagnosis is available, neoadjuvant imatinib should be prescribed for large rectal GISTs, as it significantly decreases both tumour size and mitotic activity, thereby permitting less radical and sphincter-preserving surgery.
