Salvage Hepatectomy for Giant GIST Liver Metastases Unresponsive to Systemic Therapy—Case Report

Therapeutic decision-making for advanced GIST liver metastases is challenging due to limited clinical evidence. This case study aims demonstrate the survival benefit of resection in non-responsive cases. A 40-year-old male presented with abdominal pain, weight loss, altered general status, massive hepatomegaly, and intermittent melaena. He was diagnosed stage IV primary tumor ileal loop multiple gigantic synchronous bilobar metastases. Despite 31 months tyrosine-kinase inhibitor therapy post-primary resection, disease remained unresponsive. The patient admitted our tertiary center significant hepatomegaly. two-stage debulking performed after a multidisciplinary team decision. first operation debulked left hemiliver through non-anatomical ultrasound-guided segments 2, 3, 4. second (7 weeks later) right posterior sectionectomy involving 5 8. receiving line surgery, progressed both within outside liver. However, survived 55 months, postoperative 25 months. In conclusion, this emphasizes achieved complex giant metastases, even cases where systemic fails.