Gastrointestinal Stromal Tumor (GIST): An Update on Its Uncommon and Complex Presentations: A Short Review
Keywords:
Gastrointestinal stromal tumor, GIT, Unusual, C-KIT
Abstract
Gastrointestinal stromal tumor (GIST) is recently diagnosed as a tumor entity. In the past, these tumors were classified as leiomyomas, leiomyosarcomas and leiomyoblastomas.1 GISTs are the rare soft tissue sarcomas of the gastrointestinal tract (GIT), accounting for 0.1-3% of all GIT tumors.2The most common site of GIST is the stomach (60-70%) followed by small intestine (20-30%) and less common than 5% in colon, esophagus, omentum and mesentry.3The epidemiology of GIST is not known completely. Most often these cases were detected on endoscopy, on imaging of the abdomen, at surgery for the other condition or at autopsy.1The varied clinical presentations depend on the size of the tumor. Small GIST (less than 2cms) are asymptomatic and incidentally detected at endoscopy or at laparotomy.1 The large tumors give rise to vague abdominal discomfort or pain (20-50%), acute or chronic GI bleeding, intestinal obstruction (20%) or altered bowel habits and about 35% are detected incidentally. As per literature, the most common (50%) presentation is bleeding. Very large or malignant GIST presented as the exophytic palpable mass.1Regarding unusual and complex presentations of GIST, we encountered two cases of GISTs in the ten years of histopathology practice. DOI: 10.21276/AABS.2017.1330References
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2) Kramer K, Siech M, Str¨ater J, Aschoff AJ, and Henne-Bruns D. “GI hemorrhage with fulminant shock induced by jejunal gastrointestinal stromal tumor (GIST) coincident with duodenal neuroendocrine carcinoma (NET) + neurofibromatosis (NF)-Case report and review of the literature,” Zeitschrift f¨ur Gastroenterologie.2005;43(3): 281–288.
3) Miettinen M, Lasota J.Gastrointestinal Stromal tumors -definition, clinical, histological, immunohistochemical and molecular genetic features &differential diagnosis. Virchows Arch. 2001; 438:1-12.
4) Jagtap SV, Nikumbh DB, Kshirsagar AY, Bohra A, Khatib W.Malignant Gastrointestinal Stromal tumor of the Sigmoid Colon with Perforation and Peritonitis - An Unusual Presentation. International Jr of Health Sciences and Research (IJHSR). 2012;2(3):104-109.
5) Hwangbo Y , Jang JY , Kim YW , Park SD, Shim J et al. Spontaneous rupture of a sigmoid colon gastrointestinal stromal tumor manifesting as pneumoperitoneum with localized peritonitis: report of a case. Surg Today. 2011; 41(8): 1085-90.5.
6) Mujawar P, Nikumbh DB, Suryawanshi KH, Pagare PS, Thakur R. Malignant gastrointestinal stromal tumor (GIST) of the jejunum: the mysterious complex presentation. Int J Med Sci Public Health 2015;4:1168-1171
7) Fletcher CDM, Berman JJ,Corless C, Gorstein F, Lasota J, Longley BT et al . Diagnosis of Gastrointestinal Stromal tumors: a consensus approach. Hum Pathol.2002 ; 33 : 459-465.
8) Desai SR. Gastrointestinal stromal tumor.Archives of Cytology and Histopathology Research, 2016; 1(3):78-9.
2) Kramer K, Siech M, Str¨ater J, Aschoff AJ, and Henne-Bruns D. “GI hemorrhage with fulminant shock induced by jejunal gastrointestinal stromal tumor (GIST) coincident with duodenal neuroendocrine carcinoma (NET) + neurofibromatosis (NF)-Case report and review of the literature,” Zeitschrift f¨ur Gastroenterologie.2005;43(3): 281–288.
3) Miettinen M, Lasota J.Gastrointestinal Stromal tumors -definition, clinical, histological, immunohistochemical and molecular genetic features &differential diagnosis. Virchows Arch. 2001; 438:1-12.
4) Jagtap SV, Nikumbh DB, Kshirsagar AY, Bohra A, Khatib W.Malignant Gastrointestinal Stromal tumor of the Sigmoid Colon with Perforation and Peritonitis - An Unusual Presentation. International Jr of Health Sciences and Research (IJHSR). 2012;2(3):104-109.
5) Hwangbo Y , Jang JY , Kim YW , Park SD, Shim J et al. Spontaneous rupture of a sigmoid colon gastrointestinal stromal tumor manifesting as pneumoperitoneum with localized peritonitis: report of a case. Surg Today. 2011; 41(8): 1085-90.5.
6) Mujawar P, Nikumbh DB, Suryawanshi KH, Pagare PS, Thakur R. Malignant gastrointestinal stromal tumor (GIST) of the jejunum: the mysterious complex presentation. Int J Med Sci Public Health 2015;4:1168-1171
7) Fletcher CDM, Berman JJ,Corless C, Gorstein F, Lasota J, Longley BT et al . Diagnosis of Gastrointestinal Stromal tumors: a consensus approach. Hum Pathol.2002 ; 33 : 459-465.
8) Desai SR. Gastrointestinal stromal tumor.Archives of Cytology and Histopathology Research, 2016; 1(3):78-9.
Published
2017-02-21
Issue
Section
Review Articles
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