Gastrointestinal stromal tumor natural history
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]
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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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Treatment |
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Case Studies |
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Gastrointestinal stromal tumor natural history On the Web |
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American Roentgen Ray Society Images of Gastrointestinal stromal tumor natural history |
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Directions to Hospitals Treating Gastrointestinal stromal tumor |
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Risk calculators and risk factors for Gastrointestinal stromal tumor natural history |
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.
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
- Gastrointestinal bleeding
- Bowel obstruction
- Bowel perforation
- Peritonitis
- Volvulus
- Intussusception
- Surgical complications associated with resection include:
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.