Incidental Gastrointestinal Stromal Tumors (GISTs) and Bariatric Surgery: A Review

Fernández, José Antonio López; Frutos, María Dolores; Ruiz-Manzanera, Juan José

doi:10.1007/s11695-020-04853-1

Cited by 12 publications

(12 citation statements)

References 87 publications

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“…This is in line with previous reports from the review by Fernandez et al [6]. A total of 96% of tumors were smaller than 2 cm, and 99% of GISTs have a low mitotic index [6]. According to the literature, 10% to 30% of GISTs can develop into a malignant clinical course, regardless of tumor size [17,27].…”

Section: Discussionsupporting

confidence: 90%

“…In our study, no incidentally resected tumors were larger than 7 mm with a low mitotic index, and all were defined as a very low-risk tumor according to Joensuu classification [26]. This is in line with previous reports from the review by Fernandez et al [6]. A total of 96% of tumors were smaller than 2 cm, and 99% of GISTs have a low mitotic index [6].…”

Section: Discussionsupporting

confidence: 88%

“…Since recent studies suggest that the prevalence of GISTs in morbidly obese people undergoing bariatric surgery is higher than in the general population, LSG seems to be a good and safe treatment for both conditions [6].…”

Section: Introductionmentioning

confidence: 99%

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The Incidence of Gastrointestinal Stromal Tumors in Obese Patients—A Large Single Center Experience

et al. 2021

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Background and Objectives: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms located mainly in the fundus (60–70%). The incidence of GIST is approximately 10 per million population per year in Europe, with a peak incidence at the age of 63. Recent studies suggest that morbidly obese patients have a higher incidence of GIST than the general population. The aim of this study was to analyze the incidence of GIST in patients undergoing laparoscopic sleeve gastrectomy (LSG) in our department. Materials and Methods: this paper present the retrospective study of prospectively collected data of 1564 patients who underwent LSG in a single large bariatric center from October 2013 to September 2021. After surgery, each sample of the resected stomach was sent for histopathological examination. For the analysis, we included patients diagnosed with GIST intraoperatively or postoperatively. Results: GISTs were found in five patients (0.31%). There were three men and two women. The mean age was 50.2 (range 32–63 ± 11.8) and the mean preoperative body mass index was 43.3 kg/m2 (40–49.4 ± 3.2). In four cases, GISTs were found in the fundus (80%), and in one in the pylorus (20%). None of the tumors were larger than 7 mm in diameter and all were diagnosed as a very low-risk category. No adjuvant treatment was required. All patients achieved good or satisfactory bariatric and metabolic results. Conclusions: The incidence of GIST in our study was estimated at 0.31%. All patients had a very low-risk GIST and no recurrence until follow-up. Recent literature suggests that the risk of GIST is higher in the obese population, and therefore surgeons should be aware of the risk of incidental GIST during LSG.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

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The Incidence of Gastrointestinal Stromal Tumors in Obese Patients—A Large Single Center Experience

et al. 2021

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“…Gastric schwannomas seem to have good prognosis, with no recurrence, barely metastasizing to lymph nodes. Thus, laparoscopic gastric resection, near-total resection, subtotal resection and wedge resection is the most commonly used treatment, and lymphadenectomy is not routinely performed [22]. In our case, no lymph nodes are found around the lesion.…”

Section: Discussionmentioning

confidence: 65%

Gastric Schwannomas Misdiagnosed as GIST: A Comparative Study of Clinic Strategies Based on Membrane Marker Detection

Cheng

2020

J. Can. Res. Updates

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Gastric schwannomas are one of the rarest gastric tumors originating from the nerve plexus of the gut wall. Because most of these tumors don't have any specific symptom and the majority of gastric mesenchymal tumors are gastrointestinal stromal tumors (GISTs), many are therefore misdiagnosed as GISTs. In addition, gastric schwannoma is the benign and slow-growing lesion in the stomach, but GISTs had poor outcomes due to lack of response to nonsurgical interventions. In our study, we analyzed two cases of these tumors. Computer tomography (CT), contrast-enhanced CT, gastroscopy, endoscopic ultrasonography (EUS) were applied to diagnose these two patients. In addition, histological examination and immunohistochemistry (IHC) were used to confirm the final diagnosis. All imageological examination such as CT, contrast-enhanced CT, gastroscopy and EUS, diagnosed these two patients as gastrointestinal stromal tumors. Surprisingly, after the subtotal gastric surgery, histological examination showed that these lesions were composed of spindle cells. Those cells presenting in the bundle or fence-like arrangement were mildly heterologous. The outcomes of immunohistochemistry of the cell membrane markers (CD117 / DOG-1 negative, CD34 mild positive or negative) were the exact opposite of the characteristic presentation of GIST. These pathological findings refused the primary diagnosis, and were in coincidence with the characteristics of gastric schwannomas. To our best knowledge, these tumors are really rare that only two cases could be reported and analyzed clinically. CT and EUS could help diagnose gastric schwannomas before pathological examination results, but in order to define this diagnosis correctly. Pathological examination and IHC staining should be applied after surgery. To avoid the recurrence, it is better to resect the lesion completely, regardless of the malignant or benign disease.

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“…They are generally solitary tumors, identified slightly more often in males than females of middle to advanced age [ 4 ]. GISTs have been identified during bariatric surgery procedures, and studies have indicated that the incidence of GISTs was reported to be more frequent in obese patients undergoing bariatric surgery (0.6–0.8%) as compared to the general population (0.001%) [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Can Incidental Gastric GISTs During Bariatric Surgeries Change the Primary Plan of Surgery? A Single Team Experience and a Systematic Review of Literature

Abokhozima,

Zidan,

Altabbaa

et al. 2024

OBES SURG

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As bariatric surgeries (BS) increase, more incidental findings are liable to be discovered. Incidental gastric gastrointestinal stromal tumors (GISTs) during BS can be found in around 0.7% of the cases. In this article, we have performed a systematic review of the literature and added our data to those of the review to review a conceptual treatment strategy to both improve patient outcomes and decrease the risk of overall cancer. With the rise of new bariatric techniques, we have proposed a new classification to BS to enhance our description of the treatment strategy. Graphical Abstract

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Incidental Gastrointestinal Stromal Tumors (GISTs) and Bariatric Surgery: A Review

Cited by 12 publications

References 87 publications

The Incidence of Gastrointestinal Stromal Tumors in Obese Patients—A Large Single Center Experience

The Incidence of Gastrointestinal Stromal Tumors in Obese Patients—A Large Single Center Experience

Gastric Schwannomas Misdiagnosed as GIST: A Comparative Study of Clinic Strategies Based on Membrane Marker Detection

Can Incidental Gastric GISTs During Bariatric Surgeries Change the Primary Plan of Surgery? A Single Team Experience and a Systematic Review of Literature

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