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A positron emission tomography (PET)\/CT scan showed a large metabolically active distal rectal tumour of 8\u2005cm with macroscopic invasion of surrounding structures. Neoadjuvant therapy with receptor tyrosine kinase inhibitor imatinib (400\u2005mg orally daily) was initiated and an excellent partial response consisting of a significant decrease in the size of the tumour with complete metabolic resolution was observed within 3\u2005months. Six months after initiation of the neoadjuvant therapy a rectum resection with manual side-to-end coloanal anastomosis was performed. Pathology showed a GIST of 5\u2005cm located 0.1\u2005cm from the distal section plane. Our case shows that in patients with a large invasive distal rectal GIST, neoadjuvant imatinib therapy can facilitate anal sphincter sparing surgery.<\/jats:p>","DOI":"10.1136\/bcr-2014-207775","type":"journal-article","created":{"date-parts":[[2015,1,8]],"date-time":"2015-01-08T14:45:38Z","timestamp":1420728338000},"page":"bcr2014207775","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Sphincter sparing resection of a large obstructive distal rectal gastrointestinal stromal tumour after neoadjuvant therapy with imatinib (Glivec)"],"prefix":"10.1136","volume":"2015","author":[{"given":"Kelvin Harvey","family":"Kramp","sequence":"first","affiliation":[{"name":"Department of Surgery, Medical Centre Leeuwarden, Leeuwarden, Friesland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohab Galal","family":"Omer","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Schoffski","sequence":"additional","affiliation":[{"name":"Department of General Medicine Oncology, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andre","family":"d'Hoore","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,1,8]]},"reference":[{"key":"2025082722222032000_2015.jan08_1.bcr2014207775.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.40709.x"},{"key":"2025082722222032000_2015.jan08_1.bcr2014207775.2","doi-asserted-by":"publisher","DOI":"10.1126\/science.279.5350.577"},{"key":"2025082722222032000_2015.jan08_1.bcr2014207775.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra013339"},{"key":"2025082722222032000_2015.jan08_1.bcr2014207775.4","doi-asserted-by":"crossref","unstructured":"Naranjo CA, Busto U, Sellers EM, et al. 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