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Revision as of 23:32, 26 November 2017
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Gastrointestinal stromal tumor Microchapters |
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Differentiating Gastrointestinal stromal tumor from other Diseases |
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Diagnosis |
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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.
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.
Differential Diagnosis
Gastrointestinal stromal tumor must be differentiated from gastrointestinal leiomyoma, gastrointestinal leiomyosarcoma, gastrointestinal lymphoma / gastric lymphoma, gastrointestinal schwannoma and gastrointestinal carcinoid.
Natural history
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.
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.
Other Imaging Findings
Fluoroscopy may be helpful in the diagnosis of gastrointestinal stromal tumor.
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.