Gastrointestinal stromal tumor natural history: Difference between revisions

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{{CMG}}{{AE}}{{PSD}}
{{CMG}}{{AE}}{{Akshun}}
{{Gastrointestinal stromal tumor}}
{{Gastrointestinal stromal tumor}}


==Overview==
==Overview==
Most common site of involvement of GIST is stomach(70%).
Most common site of involvement of GIST is stomach(70%).
==Natural history==
==Natural history==
*Around 75% patients of gastrointestinal stromal tumors (GIST) are asymptomatic and are diagnosed as an incidental finding on imaging studies done for other reasons.
*Around 75% patients of gastrointestinal stromal tumors (GIST) are asymptomatic and are diagnosed as an incidental finding on imaging studies done for other reasons.
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*A ruptured GIST may lead to coffee ground emesis, black stools or even malena.
*A ruptured GIST may lead to coffee ground emesis, black stools or even malena.
*Ultimately, the GIST may metastasize and turn fatal.
*Ultimately, the GIST may metastasize and turn fatal.
Moreover, an untreated GIST located in the stomach can re
main unchanged and without metastatic lesions for a long period of time, as in our case for a 4-year period.
Moreover, an untreated GIST located in the stomach can remain unchanged and without metastatic lesions for a long period of time, as in our case for a 4-year period.
[manifestation 2], and [manifestation 3].
If left untreated gastrointestinal stromal tumors (GIST) can
*[[Stomach]]: 70%
*[[Small intestine]]: 20-25%
*Anorectum: 7%
*[[Oesophagus]]
GISTs occur not only anywhere along the gastrointestinal tract, but also in the [[mesentery]], [[omentum]] and [[retroperitoneum]], which is called  extra-gastrointestinal GISTs. Metastatic lesions may also be seen in cases of malignant extra-gastrointestinal GISTs


==Complications==
==Complications==

Revision as of 19:48, 15 December 2017


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

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Overview

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

Natural history

  • Around 75% patients of gastrointestinal stromal tumors (GIST) are asymptomatic and are diagnosed as an incidental finding on imaging studies done for other reasons.
  • If left untreated, patients with GIST may progress to develop abdominal pain, abdominal distension and perforation.
  • Depending upon the type of GIST (benign or malignant), a benign GIST may remain unchanged for years before its progression into malignancy.
  • GIST are highly vascular and an untreated tumor may attain massive size leading to intra-abdominal or gastrointestinal bleeding.
  • A ruptured GIST may lead to coffee ground emesis, black stools or even malena.
  • Ultimately, the GIST may metastasize and turn fatal.

Complications

Prognosis

  • Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary.[1]
  • Prognosis of GIST depends upon size, location, spread and mitotic rate of the tumor (mitoses per 50 high-power fields).
    • Patients with gastric GIST have been reported to have better outlook as compared to patients with extragastric GIST.
    • Patients with localized primary disease have a average survival period of 5 years.
    • Patients with malignant lesions and metastasis have an average survival period of 1-2 years.
    • Patients with mitotic rate of >10 per 50 HPF have an average survival period of 1.5-2 years
    • Patients with mitotic rate <10 per HPF have an average survival period of 8 years.

Refrences

  1. "Risk Assessment and Prognosis".


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