Current Management of Duodenal Gastrointestinal Stromal Tumors

Duodenal GIST: Surgical treatment based on the location. A single center experience with review of the literature

“…The most common duodenal portion affected by GIST is the second part, followed by the third and first parts [3,9]. This is in coherence with our results (40% GISTs were located in the second part of the duodenum).…”

“…In our series, all our patients were females, with a mean age of 63 years (52-70 years), which is also consistent with the literature [7,10]. Most patients had clinical manifestations such as hemorrhage and abdominal pain, which are the most common presentation of duodenal GISTs [9,10].…”

“…Contrast-enhanced abdominal and pelvic computed tomography (CT) scan is the investigation of choice for staging and follow-up. GISTs are hypervascular tumors appearing as well-defined endophytic or exophytic masses on contrast enhanced images, the tumor is strongly enhanced in the arterial phase and this enhancement may last until the delayed venous phase [9]. In our study, all patients were diagnosed by CT.…”

“…The differential diagnosis includes other soft tissue tumors including leiomyoma adenocarcinoma, leiomyoma, leiomyosarcoma, fibrosing mesenteritis, lipoma, mesenteric lymphangioma, plexiform neurofibromatosis, ectopic pancreas, Brunner's gland cyst, schwannoma, vascular tumors, and neuroendocrine tumors [9,11].…”

“…GISTs located on the anti-mesenteric side (lateral wall) in D2 and those not located in the periampullary region can be limitedly resected with local resection or segmental duodenectomy depending on the circumferential extension. Primary closure of the duodenal wall can be achieved through transverse suture, and if there is risk of duodenum lumen stenosis, side-to-end duodenojejunostomy or Roux-en-Y side-toside duodenojejunostomy [9,18].…”