Rare gastrointestinal stromal tumors (GIST): omentum and retroperitoneum

Sawaki, Akira

doi:10.21037/tgh.2017.12.07

Cited by 24 publications

(22 citation statements)

References 24 publications

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“…Primary tumors are rare with limited information in the literature and include EGIST, adenocarcinoma, sarcomas, and leiomyomas. In contrast to GISTs, EGISTs are associated with younger age at presentation, poorer prognosis, and high risk of local recurrence (70). At MRI, they manifest as exophytic heterogeneously enhancing masses compressing the rectum or vagina.…”

Section: Vesicovaginal Space and Rectovaginal Fasciamentioning

confidence: 99%

MRI of Tumors and Tumor Mimics in the Female Pelvis: Anatomic Pelvic Space–based Approach

Nougaret¹,

Nikolovski²,

Paroder³

et al. 2019

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Section: Vesicovaginal Space and Rectovaginal Fasciamentioning

confidence: 99%

MRI of Tumors and Tumor Mimics in the Female Pelvis: Anatomic Pelvic Space–based Approach

Nougaret¹,

Nikolovski²,

Paroder³

et al. 2019

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“…GISTs are rare, with relative annual incidence of 14.5 per million and prevalence of 129 per million (6). GIST may occur anywhere in the digestive tract, but are more frequently located in the stomach (60-70%) and midgut (25%) and less often in colon and rectum (5-10%) (7). Extravisceral GIST occurs in less than 10% of patients, most frequently in mesentery, intrabdominal, pelvis and retroperitoneal space (7).…”

Section: Introductionmentioning

confidence: 99%

“…GIST may occur anywhere in the digestive tract, but are more frequently located in the stomach (60-70%) and midgut (25%) and less often in colon and rectum (5-10%) (7). Extravisceral GIST occurs in less than 10% of patients, most frequently in mesentery, intrabdominal, pelvis and retroperitoneal space (7). Duodenal GISTs (dGIST) represent only 4-5% of all GISTs, but accounted for 6-21% of surgical resected ones (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment of gastrointestinal stromal tumors of the duodenum: a literature review

Popivanov¹,

Tabakov²,

Mantese³

et al. 2018

Transl. Gastroenterol. Hepatol

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Background: Gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal tumours in the digestive tract. The duodenal GIST (dGIST) is the rarest subtype, representing only 4-5% of all GIST, but up to 21% of the resected ones. The diagnostic and therapeutic management of dGIST may be difficult due to the rarity of this tumor, its anatomical location, and the clinical behavior that often mimic a variety of conditions; moreover, there is lack of consent for their treatment. This study has evaluated the scientific literature to provide consensus on the diagnosis of dGIST and to outline possible options for surgical treatment.Methods: An extensive research has been carried out on the electronic databases MEDLINE, Scopus, EMBASE and Cochrane to identify all clinical trials that report an event or case series of dGIST.Results: Eighty-six studies that met the inclusion criteria were identified with five hundred forty-nine patients with dGIST: twenty-seven patients were treated with pancreatoduodenectomy and ninety-six with only local resection (segmental/wedge resections); in four hundred twenty-six patients it is not possible identify the type of treatment performed (pancreatoduodenectomy or segmental/wedge resections).Conclusions: dGISTs are a very rare subset of GISTs. They may be asymptomatic or may involve symptoms of upper GI bleeding and abdominal pain at presentation. Because of the misleading clinical presentation the differential diagnosis may be difficult. Tumours smaller than 2 cm have a low biological aggressiveness and can be followed annually by endoscopic ultrasound. The biggest ones should undergo radical surgical resection (R0). In dGIST there is no uniformly adopted surgical strategy because of the low incidence, lack of experience, and the complex anatomy of the duodenum. Therefore, individually tailored surgical approach is recommended. R0 resection with 1-2 cm clear margin is required. Lymph node dissection is not recommended due to the low incidence of lymphatic metastases. Tumor rupture should be avoided.

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“…Moreover, lesser omental leiomyosarcomas are even more infrequent with only three cases being identified using a PubMed search with the keywords “lesser omentum” and “leiomyosarcoma.” However, all three reports did not include c-kit immunostaining, which would help distinguish leiomyosarcoma from GIST [5–7]. The following omental tumors have also been reported: extra-GIST, leiomyosarcoma, fibrosarcoma, hemangiopericytoma, spindle cell sarcoma, liposarcoma, leiomyoma, lipoma, desmoid tumor, fibroma, and mesothelioma [8–12].…”

Section: Discussionmentioning

confidence: 99%

First Account of Primary Leiomyosarcoma of the Lesser Omentum since Establishment of c-Kit Mutations in Gastrointestinal Stromal Tumors

Saijo

Sato

Handa

et al. 2019

Case Reports in Surgery

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Background Primary omental leiomyosarcoma is an extremely rare type of tumor. Leiomyosarcomas originating from the lesser omentum have not been reported since immunohistochemical staining for c-kit has been used for the diagnosis of mesenchymal abdominal tumors. They are yet to be reported since gastrointestinal stromal tumors were categorized. Here we reported a case of successful resection of a lesser omental leiomyosarcoma. Case Presentation A 71-year-old man underwent ultrasonography at the outpatient clinic through which an upper abdominal tumor was identified. Following computed tomography and endoscopy, a 4.5 cm submucosal tumor in the lesser curvature of the stomach was highly suspected. A laparoscopic partial resection of the stomach was performed. Histopathological examination revealed the tumor to be a leiomyosarcoma arising from the lesser omentum that did not invade the stomach. Immunohistochemical staining showed that the tumor was negative for CD34, c-kit, and S-100 and positive for desmin and α-smooth muscle actin. No recurrence had been observed 1 year after surgery without adjuvant chemotherapy. Conclusions Primary lesser omental leiomyosarcoma, which is difficult to diagnose before surgery given the location of the primary tumor in the lesser omentum, has rarely been reported. Considering the high possibility of malignancy, close observation is essential.

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Rare gastrointestinal stromal tumors (GIST): omentum and retroperitoneum

Cited by 24 publications

References 24 publications

MRI of Tumors and Tumor Mimics in the Female Pelvis: Anatomic Pelvic Space–based Approach

MRI of Tumors and Tumor Mimics in the Female Pelvis: Anatomic Pelvic Space–based Approach

Surgical treatment of gastrointestinal stromal tumors of the duodenum: a literature review

First Account of Primary Leiomyosarcoma of the Lesser Omentum since Establishment of c-Kit Mutations in Gastrointestinal Stromal Tumors

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