Gastrointestinal Stromal Tumors of the Distal Gastrointestinal Tract

Abstract

Gastrointestinal stromal tumors (GISTs) are rare in occurrence, but comprise the most common mesenchymal tumors of the gastrointestinal tract and affect between 15 and 20 individuals per million per year. Due to recent advancements in molecular classification of these tumors, medical therapy has provided improved outcomes to a historically surgically managed disease. This review article briefly discusses the molecular characteristics, medical and surgical therapies, and future of GIST management.

Duodenojejunal intussusception secondary to primary gastrointestinal stromal tumor: A case report

“…Although these reports have selection bias, LR seems to be better in selected cases because there is no difference in recurrence between LR and PD [5]. The location in relation to the Vater papilla, tumor size, and a 1- to 2-cm resection margin should be considered when selecting the type of surgical resection [5,16]. Injury to the GIST capsule should be avoided, and adjacent organs should be resected if the GIST invades them [5,16].…”

“…The peritoneum and liver are the most common sites of metastasis, whereas regional lymph node metastasis is rare (0–10%), except in Carney’s triad [2,5,8,13,17]. Therefore, the necessity of regional lymph node resection is unknown, and extensive lymphadenectomy is not recommended [2,13,16]. In this case, only two lymph nodes interfering with anastomosis were resected with caution for vascular injury, which can lead to an increase in resection range.…”

Gastrointestinal Stromal Tumors, Neuroendocrine Tumors, and Lymphoma

“…Without mucosal ulceration, the diagnostic yield from mucosal biopsy is low. The diagnostic yield of endoscopy can be enhanced with the addition of endoscopic ultrasound (EUS) and fine needle aspiration (FNA) [16,17]. Percutaneous biopsy is an option for tumors deemed inaccessible by endoscopy.…”

“…Contrast-enhanced computed tomography (CT), specifically CT enterography, and magnetic resonance imaging (MRI) are often the initial imaging modalities and may aid in determining tumor location, perforation, invasion to nearby structures, and distant metastasis [17]. GISTs typically involve the muscularis propria and radiographically have the appearance of a well-circumscribed mass.…”

Colorectal Nonadenocarcinoma in South Korea

“…The median age at diagnosis of GISTs is 60 years, and GISTs do not have any sex or race predominance [ 11 ]. Surgical resection remains the gold standard management for GISTs, and imatinib is currently used in the neoadjuvant, adjuvant, and metastatic disease setting [ 12 ].…”