scholarly journals Treatment Results of Small Intestinal Gastrointestinal Stromal Tumors Less than 10 cm in Diameter: A Comparison between Laparoscopy and Open Surgery

2012 ◽  
Vol 12 (4) ◽  
pp. 243 ◽  
Author(s):  
Kyong Ihn ◽  
Woo Jin Hyung ◽  
Hyoung-Il Kim ◽  
Ji Yeong An ◽  
Jong Won Kim ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Open Surgery ◽  
Treatment Results ◽  
Stromal Tumors ◽  
Small Intestinal

scholarly journals Multiple Gastric Gastrointestinal Stromal Tumors in a Patient with Neurofibromatosis Type 1

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Makoto Tomatsu ◽  
Jun Isogaki ◽  
Takahiro Watanabe ◽  
Kiyoshige Yajima ◽  
Takuya Okumura ◽  
...  
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Gastrointestinal Stromal Tumors ◽  
Kinase Inhibitor ◽  
Submucosal Tumor ◽  
Neurofibromatosis Type ◽  
Stromal Tumors ◽  
Serosal Surface ◽  
History Of ◽  
Small Intestinal

Gastrointestinal stromal tumors (GISTs) are relatively common in neurofibromatosis type 1 (NF 1) patients. Approximately 90% of GISTs associated with NF 1 are located in the small intestine, while sporadic GISTs are most commonly located in the stomach. Here we report an extremely rare case of an NF 1 patient with multiple gastric GITs (90 or more) but without multiple small intestinal tumors. A 63-year-old female patient who had a history of NF 1 underwent surgery for a gastric neuroendocrine tumor and gastric submucosal tumor (SMT). During the operation, multiple small nodules were identified on the serosal surface of the upper stomach. SMT and multiple nodules on the serosal surface were diagnosed as GISTs consisting of spindle cells positive for KIT, CD34, and DOG-1. Both GIST and the normal gastric mucosa showed no mutations not only in the c-kitgene (exons 8, 9, 11, 13, and 17) but also in thePDGFRAgene (exons 12, 14, and 18). This patient is being followed up without the administration of a tyrosine kinase inhibitor.

scholarly journals A Retrospective Analysis to Validate the Alarm Signs Used in the CEDAP-Plus Study

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Hou-De Zhang ◽  
Mu-Xian Lin ◽  
Qu Zhang
Keyword(s):  
Abdominal Pain ◽  
Capsule Endoscopy ◽  
Gastrointestinal Stromal Tumors ◽  
Demographic Data ◽  
Chronic Abdominal Pain ◽  
Chronic Anemia ◽  
Stromal Tumors ◽  
Loss Of Weight ◽  
Small Intestinal ◽  
Low Sensitivity

Background and Study Aim. This study aimed to validate the alarm signs used in the 2007 German CEDAP-Plus study for indicating capsule endoscopy in patients who have idiopathic chronic abdominal pain. Patients and Methods. We retrospectively reviewed the cases of all patients who underwent capsule endoscopy at our institution between August 2007 and August 2009 for chronic hitherto undiagnosed abdominal pain, despite previous investigations. The demographic data, indications, findings, and diagnoses were recorded, as were the alarm signs (i.e., 10% loss of weight within 3 months, suspected small intestinal bleed or chronic anemia, and laboratory indications of inflammation). Results. Alarm signs were found in only 4 of the 62 included patients. Capsule endoscopy revealed findings that led to diagnoses of Crohn's disease (), tuberculosis (), gastrointestinal stromal tumors (), and hookworm (); these diagnoses included 100% (4/4) of the patients with alarm signs, but only 8.6% (5/58) of patients without them. However, 55.6% (5/9) of patients with clinically capsule endoscopy findings reported no alarm signs. Conclusions. Although selecting patients based on the alarm signs may increase the yield of capsule endoscopy, the alarm sign criteria appear to have low sensitivity.

Gastrointestinal Stromal Tumors: Review on Morphology, Molecular Pathology, Prognosis, and Differential Diagnosis

2006 ◽  
Vol 130 (10) ◽  
pp. 1466-1478 ◽  
Author(s):  
Markku Miettinen ◽  
Jerzy Lasota
Keyword(s):  
Smooth Muscle ◽  
Gastrointestinal Tract ◽  
Tyrosine Kinase ◽  
Gastrointestinal Stromal Tumors ◽  
Intestinal Tumors ◽  
Secondary Resistance ◽  
Prognostic Features ◽  
Stromal Tumors ◽  
Small Intestinal ◽  
Domain Exon

Abstract Context.—Gastrointestinal stromal tumors (GISTs) are specific, generally Kit (CD117)-positive, mesenchymal tumors of the gastrointestinal tract encompassing a majority of tumors previously considered gastrointestinal smooth muscle tumors. They are believed to originate from interstitial cells of Cajal or related stem cells. Objective.—To review current clinicopathologically relevant information on GIST. Data Sources.—Literature in Medline and authors' own experience. Conclusions.—GISTs usually occur in older adults (median age 55–60 years) and rarely in children in the second decade (<1%) throughout the gastrointestinal tract: 60% in stomach, 35% in small intestine, and less than 5% in rectum, esophagus, omentum, and mesentery; most GISTs in the latter 2 sites are metastatic. Five percent of GISTs occur in patients with neurofibromatosis type 1 syndrome (multiple small intestinal tumors) and in Carney triad (gastric epithelioid GISTs in young females). Familial GISTs occur in patients with inheritable germline Kit or platelet-derived growth factor receptor alpha (PDGFRA) mutations. Histologically GISTs vary from spindle cell tumors to epithelioid and pleomorphic tumors. Most GISTs (95%) express Kit (CD117), CD34 (70%), and heavy caldesmon (80%), whereas 25% are positive for smooth muscle actin and less than 5% for desmin. Tumor size and mitotic activity are best predictive prognostic features; small intestinal tumors behave more aggressively than gastric tumors with similar parameters. Mutually exclusive gain-of-function Kit or PDGFRA mutations occur in a majority of GISTs representing in-frame deletions, point mutations, duplications and insertions. Mutations in Kit juxtamembrane domain (exon 11) are the most common in GISTs of all sites, whereas rare Kit extracellular domain (exon 9) Ala502-Tyr503 duplication is specific for intestinal GISTs. Mutations in PDGFRA have been identified in juxtamembrane (exon 12) and tyrosine kinase domains (exons 14 and 18), nearly exclusively in gastric GISTs, mostly in epithelioid variants. Some Kit and PDGFRA mutations have a prognostic value. Kit/PDGFRA tyrosine kinase inhibitor imatinib has been successfully used in the treatment of metastatic GISTs for more than 5 years. However, primary and acquired secondary resistance linked to certain types of Kit and PDGFRA mutations is limiting long-term success necessitating the use of alternative treatments.

EXPECT THE UNEXPECTED: JEJUNAL GASTROINTESTINAL TUMOUR MIMICKING OVARIAN MALIGNANCY- A CASE REPORT WITH REVIEW OF LITERATURE

2021 ◽  
pp. 12-13
Author(s):  
Shivangi Singh ◽  
Munesh Munesh ◽  
Sweta Sweta
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Alimentary Tract ◽  
Ovarian Malignancy ◽  
Review Of Literature ◽  
Gastrointestinal Stromal Tumours ◽  
Stromal Tumors ◽  
Epitheloid Cells ◽  
Missed Diagnosis ◽  
Small Intestinal ◽  
Mesenchymal Tumours

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours of alimentary tract comprising 0.2% of gastrointestinal tumors and only 0.04% of small intestinal tumours. Jejunal GISTs are one of the rarest subtypes. GISTs display various morphological forms like spindle and epitheloid cells in a variety of patterns and can be submucosal, intramuscular or subserosal in location. Grossly they are solid and cyst with variable hemorrhage and necrosis. Most of the gastrointestinal stromal tumors have mutations in either KIT (CD117) or PDGFRα gene. DOG 1 is a sensitive and specic marker of GIST independent of CD117 or PGDFRα expression. Here we present a case of malignant jejunal GIST with missed diagnosis on CECT abdomen.

scholarly journals “Dovetail” gastric resection: a novel model in the treatment of gastrointestinal stromal tumors

2020 ◽  
Vol 2 (4) ◽  
pp. First
Author(s):  
Denise Gambardella ◽  
Angelo Aldo Schicchi ◽  
Andrea Boccuto ◽  
Vito Bilotta ◽  
Ettore Caruso ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Open Surgery ◽  
Gastric Resection ◽  
Gastric Antrum ◽  
Gastric Gist ◽  
Stromal Tumors ◽  
Frequent Site ◽  
Subepithelial Lesions ◽  
Technical Solutions ◽  
Preoperative Examination

Gastrointestinal stromal tumors (GISTs) are the most common malignant subepithelial lesions of the gastrointestinal tract. The prognosis of this disease is associated with the tumor size and mitotic index. The standard treatment of a GIST without metastasis is surgical resection. The stomach is the most frequent site of the disease and many technical solutions have recently been proposed as shown also by the dramatic increase in publications on this field. There are many studies that suggest laparoscopy may be an acceptable surgical treatment option compared to open surgery for gastric GIST. However, open surgery assumes great importance in large tumors located in difficult to access locations. Here, we present a case involving a 60-year-old man who was diagnosed with gastric antrum GIST, according to a preoperative examination and postoperative pathology. Then, the patient successfully underwent an atypical gastric resection. We proposed a novel surgical technique to be considered in case of gastric benign disease or GIST localized at the gastric antrum.

scholarly journals Radical Versus Non-Radical Resection for Small intestinal Gastrointestinal Stromal Tumors: A Propensity Score-Matched Analysis

2021 ◽  
Author(s):  
Linlin Yin ◽  
Haihao Yan ◽  
Jue Lin ◽  
Zuhong Ji ◽  
Guozhong Ji ◽  
...  
Keyword(s):  
Propensity Score ◽  
Gastrointestinal Stromal Tumors ◽  
Radical Surgery ◽  
Radical Resection ◽  
Term Survival ◽  
Long Term Survival ◽  
Resection Group ◽  
Stromal Tumors ◽  
Small Intestinal

Abstract Surgical resection is the first choice for the treatment of small intestinal gastrointestinal stromal tumors (GISTs), but the best surgical method for small intestinal stromal tumors remains undefined. It is not clear whether there is a difference in the long-term survival of small intestinal GISTs between radical surgery and non-radical surgery. We included 877 patients with small intestinal stromal tumors who underwent surgery between 2010 and 2015 from the SEER database. They were divided into the radical resection group and the non-radical resection group. To minimized the selection bias and mixed bias in the comparison, propensity score matching (PSM) and multivariate regression analysis were carried out. In the entire cohort, 120 patients underwent radical surgery and 757 patients received non-radical resection. The 1, 3, and 5-year OS rates were 95.7%, 80.2%, and 69.6% in the radical resection group versus 94.3%, 86.8%, and 77.2% in the non-radical resection group, respectively. (p=0.069) Meanwhile, radical resection had the similar CSS rates of 1, 3 and 5-year compared with non-radical surgery. (1-year CSS rate: 97.4% vs. 98.0%, 3-year CSS rate: 86.1% vs. 93.2%, 5-year CSS rate: 81.6% vs. 88.3%; p =0.056) Besides, after adjusting for other clinical factors and PSM, the long-term OS and CSS did not significantly differ between radical surgery and non-radical surgery. Our study preliminarily found that for small intestinal GISTs, there was no significant difference in long-term survival between radical surgery and non-radical surgery.

Laparoscopy-Assisted versus Open Surgery for Gastrointestinal Stromal Tumors of Jejunum and Ileum: Perioperative Outcomes and Long-Term Follow-Up Experience

2012 ◽  
Vol 78 (12) ◽  
pp. 1399-1404 ◽  
Author(s):  
Ping Wan ◽  
Chen Li ◽  
Min Yan ◽  
Chao Yan ◽  
Zheng Gang Zhu
Keyword(s):  
Gastrointestinal Stromal Tumors ◽  
Open Surgery ◽  
Postoperative Outcomes ◽  
Open Group ◽  
Perioperative Outcomes ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Stromal Tumors ◽  
Significant Difference

Whether laparoscopy-assisted resections for gastrointestinal stromal tumors (GISTs) of small bowel can achieve more benefits on the aspect of postoperative outcomes than open surgery remains a question. The aim of this study is to evaluate the benefits of laparoscopy-assisted surgery for GISTs of jejunum and ileum on the perioperative outcomes and long-term relapse-free survival. From January 2004 to December 2010, 81 patients who underwent either laparoscopy-assisted (LAP group, n = 43) or open surgery (OPEN group, n = 38) were included in final analysis after the eligibility criteria. Clinicopathological characteristics of the selected patients were similar between the two groups. Oral intake was significant earlier ( P < 0.001) and postoperative hospital stay duration was significantly shorter ( P < 0.001) in the LAP group than in the OPEN group. The complication rate of patients in the LAP group and OPEN group was 9.3 and 26.3 per cent, respectively ( P = 0.04). No significant difference was observed in terms of 5-year relapse-free survival between LAP and OPEN groups (91.1 vs 93.8%, P = 0.4). Laparoscopy-assisted surgery for GISTs of jejunum and ileum could get preferable short-term postoperative outcomes and similar long-term relapse-free survival compared with open surgery, so it should be recommended for GISTs of the small intestine.

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