Cytoreductive surgery alone for recurrent, metastatic, or unresectable GISTs
is not recommended.
His upper gastrointestinal endoscopy revealed an oval shaped mass over anterior wall of stomach at cardia, along lesser curvature suggestive of GIST
The histopathologic findings matched GIST
with a high probability of relapse according to the localization, size, mitotic activity and Ki-67 values.
In addition to CD117 and DOG-1, GISTs
are typically positive for CD34 and show variable positivity for smooth muscle actin (SMA) on immunohistochemistry (Figure 2, A through C).
with 1-5 mitosis/ 50 HPF are classified as a low grade, and GISTs
with a mitosis of 10/10 HPF are classified as high-grade group.
Extended node dissection is not indicated in surgery for GISTs
, and it was never performed.
Imatinib, the target therapy for GISTs
and a selective tyrosine kinase inhibitor, primarily acts on tyrosine kinase: Abl, c-kit, and platelet-derived growth factor receptor.
Imatinib mesylate is indicated in patients with advanced GISTs
In differential diagnosis, tumors that must be separated from LMSs and colonic GISTs
include the uterine-type LMs attached to the colon but arising externally to it (uniformly positive for actin and desmin), inflammatory myofibroblastic tumors (nega tive for CD117) and inflammatory fibrosarcoma, liposarcoma adherent to the colon (negative for CD117), and schwannoma (diffusely positive for S-100 protein and negative for CD117 and CD34) .
are generally asymptomatic; however, they can also present as abdominal pain, bleeding, or mechanical obstruction.
During 5 years (2007-2012), we retrieved 50 cases of GISTs
from the archives of the affiliated hospitals of Shiraz University of Medical Sciences.
2) Perhaps, the most critical development that distinguished GIST
as a unique clinical entity was the discovery of c-kit proto-oncogene gain-of-function mutations in these tumors by Hirota and collegues in 1998.
can arise from all parts of the gastrointestinal tract--stomach (50-60%), small intestine (30-40%), colon/rectum (5-10%) and esophagus (5%) (Stamatakos, Douzinas, Stefanaki, Safioleas et al.
can be seen as either spindled, epithelioid cells or as a combination of both of these cell types.
The discovery of oncogenic KIT kinase mutations in GISTs
and the introduction of kinase inhibitor therapies have led to a rapid evolution in the understanding of these tumors.