Gastrointestinal stromal tumor overview

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Overview

Historical Perspective

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Differentiating Gastrointestinal stromal tumor from other Diseases

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

In medical oncology, gastrointestinal stromal tumors (GIST) are a rare tumor of the gastrointestinal tract. GIST is a form of connective tissue cancer, or sarcoma. GISTs are therefore non-epithelial tumors, separate from more common forms of bowel cancer. Majority of the cases occur in the stomach(70%), 20% of cases in the small intestine and less than 10% in the esophagus. Small tumors are generally benign, especially when cell division rate is slow, but large tumors disseminate to the liver, omentum and peritoneal cavity. They rarely occur in other abdominal organs. Gastrointestinal stromal tumor affects men and women equally.

Historical Perspective

Pathophysiology

On microscopic histopathological analysis, spindle cells or plump epithelioid cells are characteristic findings of gastrointestinal stromal tumor.

Causes

There are no established causes for gastrointestinal stromal tumor.

Epidemiology and Demographics

Gastrointestinal stromal tumor affects men and women equally.

Risk factors

The most potent risk factor in the development of GISTs are age 50-80 and certain genetic syndromes like neurofibromatosis type 1, Carney-Stratakis syndrome and familial gastrointestinal stromal tumor syndrome.

Screening

Differential Diagnosis

Gastrointestinal stromal tumor must be differentiated from gastrointestinal leiomyoma, gastrointestinal leiomyosarcoma, gastrointestinal lymphoma / gastric lymphoma, gastrointestinal schwannoma and gastrointestinal carcinoid.

Natural History, Complications and Prognosis

Most common site of involvement of GIST is stomach(70%).

Staging

According to the American Joint Committee on Cancer, there are 4 stages of gastrointestinal stromal tumor based on the tumor spread.

History and Symptoms

Symptoms of gastrointestinal stromal tumor include dysphagia, gastrointestinal hemorrhage, and vague abdominal pain.

Physical Examination

Laboratory Examination

Abdominal X-ray

On abdominal X-ray, gastrointestinal stromal tumor is characterized by soft tissue density displacing bowel loops.

CT scan

Abdominal CT scan may be helpful in the diagnosis of gastrointestinal stromal tumor.

MRI

MRI scan may be helpful in the diagnosis of gastrointestinal stromal tumor.

Ultrasound

Other Imaging Findings

Fluoroscopy may be helpful in the diagnosis of gastrointestinal stromal tumor.

Other Diagnostic studies

Medical Therapy

The predominant therapy for gastrointestinal stromal tumor is surgical resection. Adjunctive chemotherapy/tyrosine Kinase Inhibitor therapy may be required.

Surgical Therapy

The predominant therapy for gastrointestinal stromal tumor is surgical resection. Adjunctive chemotherapy/tyrosine Kinase Inhibitor therapy may be required.

Prevention

References


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