Gastric gastrointestinal stromal tumours (2-5 cm): Correlation of CT features with malignancy and differential diagnosis

Chen, Zeyang; Yang, Jiejin; Sun, Jiali; Wang, Pengyuan

doi:10.1016/j.ejrad.2019.108783

Cited by 24 publications

(29 citation statements)

References 24 publications

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“…Notably, to our knowledge, this study reports the largest series of Chinese EES cases to date. Consistent with the available literature, the male preponderance of EES was also observed in our sample (10,(15)(16)(17). Researches report that SES patients are younger than EES patients (1,10,13).…”

Section: Discussionsupporting

confidence: 92%

Extraskeletal Ewing’s sarcoma: outcomes and CT features of endoceliac lesions

Chen¹,

Jiao²,

Liu³

et al. 2021

Transl Cancer Res TCR

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Background: Extraskeletal Ewing's sarcoma (EES) is one kind of rare malignant tumour which is always misdiagnosed preoperatively, especially for lesions located at endoceliac sites. This study analyse the clinicopathological features and outcomes of EES patients. The basic imaging characteristics of endoceliac lesions are also summarized.Methods: This study involved EES patients admitted to our centre between January 2000 and January 2020. Clinical data from patients with EES (n=25) and computed tomography (CT) features from endoceliac EES patients with available CT data (n=8) were retrospectively reviewed. Results:The sample comprised 18 males and 7 females with a median age of 30 years (range, 1-72 years).Seven patients had EES originating from surface sites and 18 had EES originating from endoceliac sites.The median tumour size was 8.0 cm (range, 2.5-17.0 cm). In total, 20% of patients had distant metastasis at diagnosis. In the univariate analyses, tumour size >8 cm, non-surgical treatment, and regional lymph nodes metastasis were risk factors for poor prognosis of EES. In the multivariate analysis, patients with larger tumour size and regional lymph node metastasis were independent predictors of overall survival (OS).Endoceliac EES cases frequently exhibited lobulated contour (87.5%), absence of calcification (75%), severe necrosis or cystic degeneration (75%), heterogeneous enhancement (100%), moderate enhancement (75%), ill-defined borderline (62.5%), and organ invasion (75%). Half of the patients with endoceliac EES had CT features of lymphadenopathy.Conclusions: Comprehensive understanding of the clinicopathological and imaging features of EES is beneficial for diagnosis, development of therapeutic strategies, and accurate prediction of prognosis for this rare malignant tumour.

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Section: Discussionsupporting

confidence: 92%

Extraskeletal Ewing’s sarcoma: outcomes and CT features of endoceliac lesions

Chen¹,

Jiao²,

Liu³

et al. 2021

Transl Cancer Res TCR

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“…In this study, however, small tumors were also included. The evaluation of the intraluminal or extraluminal growth pattern is still arbitrary and probably involves many pitfalls; however, it is still present in some of such studies [15,16,25]. In our study, if more than half of the lesions are intraluminal, we labeled them as intraluminal and, vice versa, extraluminal.…”

Section: Discussionmentioning

confidence: 99%

“…The authors reported poor agreement when interpreting echogenicity and irregular luminal borders but good agreement on heterogeneity and irregular extraluminal borders. Another possible reason for the different outcomes among the studies is that the occurrence of some EUS features is not just associated with the biological behavior of tumors [25]. Choi et al [26] reported that the presence of surface ulceration has no direct correlation with aggressive tumor behavior and results from the ischemic mucosa being pressed on by the growing tumor.…”

Section: Discussionmentioning

confidence: 99%

“…However, another group claimed that large tumors tend to grow toward the gastric lumen and lead to mucosal ulceration associated with malignancy [16]. Chen et al [25] claimed that cystic spaces correspond to cystic degeneration and liquefaction necrosis, and the disproportionality between the rapid tumor growth and relatively slow neovascularization can induce necrosis or cystic degeneration. As a result of malignant changes, GISTs usually have a heterogeneous echo texture with hyperechoic spots or anechoic areas, especially in larger tumors.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of Endoscopic Ultrasonography Features with the Mitotic Index in 2- to 5-cm Gastric Gastrointestinal Stromal Tumors

Seven

Arıcı

Şentürk

2021

Dig Dis

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Background: Predicting the malignancy potential of gastrointestinal stromal tumor (GIST) before resection could improve patient management strategies, as gastric GISTs with a low malignancy potential can be safely treated endoscopically, but surgical resection is required for those tumors with a high malignancy potential. This study aimed to evaluate endoscopic ultrasound (EUS) features of 2–5 cm gastric GISTs that might be used to predict their mitotic index using surgical specimens as the gold standard. Patients and Methods: Forty-nine patients (30 females and 19 males; mean age 55.1 ± 12.7 years) who underwent EUS examinations, followed by surgical resections of 2–5 cm gastric GISTs were retrospectively reviewed. Results: The mean tumor size was 3.44 ± 0.97 cm (range 2.1–5.0 cm). A univariate analysis revealed no significant differences in age, sex, and tumor location in the low mitotic index and high mitotic index groups (all P > 0.05). In terms of EUS features, there were no significant differences in the mitotic indexes with respect to the shape, surface lobulation, border regularity, echogenicity, homogeneity, growth patterns, presence of mucosal ulceration, hyperechogenic foci, anechoic spaces, and hypoechoic halos (all P > 0.05). However, the tumor size was larger in the high mitotic index group than in the low mitotic index group (3.97 ± 1.05 vs. 3.27 ± 0.9 cm, P = 0.03). Conclusion: Conventional EUS features are not reliable for predicting the mitotic index of 2–5 cm gastric GISTs. Further modalities for predicting the mitotic index are needed to prevent unnecessary surgical resections in patients with a low risk of malignancy.

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“…House eld units (HUs) in the portal phase, the tumour was classi ed as exhibiting necrosis or cystic degeneration, the degree of which was graded as follows: mild, < 50% low-density area in the lesion, and severe, > 50% low-density area in the lesion. The degree of enhancement was determined by comparing the CT value of the lesion to the muscle and liver in the portal phase, as described previously [19]. The enhancement pattern was classi ed as either heterogeneous or homogeneous.…”

Section: Ct Imaging Analysismentioning

confidence: 99%

Extraskeletal Ewing’s sarcoma: outcomes and CT features of endoceliac lesions

Chen

Yang

Liu

et al. 2020

Preprint

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Background To analyse the clinicopathological features and outcomes of patients with extraskeletal Ewing’s sarcoma (EES). The basic imaging characteristics of endoceliac lesions, which are always misdiagnosed preoperatively, are also summarised.Methods This study involved EES patients admitted to our centre between January 2000 and January 2020. Clinical data from patients with EES (n = 25) and computed tomography (CT) data from patients with endoceliac lesions (n = 8) were retrospectively reviewed.Results The sample comprised 18 males and 7 females with a median age of 30 years (range 1–72 years). Seven patients had EES originating from surface sites and 18 had EES originating from endoceliac sites. The median tumour size was 8.0 cm (range 2.5–17.0 cm). In total, 20% of patients had distant metastasis at diagnosis. In the univariate analyses, tumour size > 8 cm, undergoing surgery, and regional lymph nodes metastasis were risk factors for poor prognosis of EES. In the multivariate analysis, patients undergoing surgery and regional lymph node metastasis were independent predictors of overall survival (OS). Endoceliac EES cases frequently exhibited lobulated contour (87.5%), absence of calcification (75%), severe necrosis or cystic degeneration (75%), heterogeneous enhancement (100%), moderate enhancement (75%), ill-defined borderline (62.5%), and organ invasion (75%). Half of the patients with endoceliac EES had CT features of lymphadenopathy.Conclusions Comprehensive understanding of the clinicopathological and imaging features of EES is beneficial for diagnosis, development of therapeutic strategies, and accurate prediction of prognosis for this rare malignant tumour. The results suggest that evaluation of the status of regional lymph nodes is important for the treatment of EES.

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Gastric gastrointestinal stromal tumours (2-5 cm): Correlation of CT features with malignancy and differential diagnosis

Cited by 24 publications

References 24 publications

Extraskeletal Ewing’s sarcoma: outcomes and CT features of endoceliac lesions

Extraskeletal Ewing’s sarcoma: outcomes and CT features of endoceliac lesions

Correlation of Endoscopic Ultrasonography Features with the Mitotic Index in 2- to 5-cm Gastric Gastrointestinal Stromal Tumors

Extraskeletal Ewing’s sarcoma: outcomes and CT features of endoceliac lesions

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