Small Bowel Stromal Tumors: Different Clinicopathologic and Computed Tomography Features in Various Anatomic Sites

Gusheng, Xing; Wang, Shuang; Sun, Yihong; Yuan, Zheng; Zhao, Xinming; Zhou, Chunwu

doi:10.1371/journal.pone.0144277

Cited by 26 publications

(23 citation statements)

References 26 publications

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“…In previously published studies, GIST of the small bowel has been reported to show a slight male predominance. 10 , 12 , 13 However, the findings from this study showed there were equal numbers of men and women, which may have been due to the small study sample size. However, the median age of the patients in the present study was 56 years, which was similar to previously reported case series.…”

Section: Discussionmentioning

confidence: 56%

“… 6 , 7 The diagnosis of GIST of the small bowel may be delayed for several reasons, including its relatively low incidence, nonspecific and variable symptoms, the wide spectrum of radiological appearances, intestinal thickening, and the presence of overlapping loops of intestine, which make imaging studies difficult; all of these lead to delayed or misdiagnosis of GIST of the small bowel. 8 – 10 …”

Section: Introductionmentioning

confidence: 99%

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Small bowel gastrointestinal stromal tumor: a retrospective study of 32 cases at a single center and review of the literature

Zhou

Liao

et al. 2018

TCRM

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BackgroundGastrointestinal stromal tumor (GIST) is a rare tumor of the small bowel, which can be difficult to diagnose and has a varied clinical outcome.PurposeThis is a retrospective review of the diagnosis, management, and clinical outcome of 32 patients diagnosed with primary small bowel GIST from a single center and a comparison of the findings with previously published cases.Patients and methodsRetrospective review of data from patient clinical records, endoscopic and imaging findings, surgical procedures, tumor histology and immunohistochemistry, and clinical outcome was conducted.ResultsData of 32 patients with a median age of 56 years including 50% men and women were reviewed. The majority (29/32) were symptomatic at presentation, with the main symptom being gastrointestinal bleeding (15/32). Imaging detection rates included ultrasound (0%), magnetic resonance imaging (0%), computed tomography (54.8%), computed tomography angiography (71.4%), and double-balloon enteroscopy (88.9%). The mean tumor diameter was 5.3 cm; 4 tumors were located in the duodenum, 21 in the jejunum, and 7 in the ileum. Based on the tumor size and mitotic index, 5 (15.6%), 15 (46.9%), 0 (0%), and 12 (37.5%) patients were classified into very low-risk, low-risk, intermediate-risk, and high-risk groups. Immunohistochemistry showed positive expression for CD117 (100%), CD34 (81.2%), DOG1 (93.8%), smooth muscle actin (37.5%), S100 (9.4%), and desmin (6.2%). Twenty-five patients (78.1%) were treated with open surgical tumor resection; seven patients (21.9%) underwent laparoscopic surgery. Postoperative complications that occurred in seven patients (21.9%) were resolved with conservative management. Four patients were treated with postoperative imatinib. At median follow-up of 30 months, two patients were died.ConclusionThe findings from this case series, combined with the findings from previously published cases, provide an update on the current status of the diagnosis and the therapeutic approaches that might lead to improvement in prognosis for patients who present with primary small bowel GIST.

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Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Small bowel gastrointestinal stromal tumor: a retrospective study of 32 cases at a single center and review of the literature

Zhou

Liao

et al. 2018

TCRM

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“…There are reports in the literature that GIST can have rare manifestations such as intestinal obstruction, perforation or rupture, abscess and intestinal stula [11,12]. However, if it is in ammation caused by GIST, such as abscess formation, it is usually acute and often accompanied by tumor central necrosis and rupture [8]. This patient has been suffering from intermittent abdominal pain and fever for 6 years, and the pathological examination of the capsule is intact.…”

Section: Discussionmentioning

confidence: 90%

“…Although there are reports in the literature that GIST can have rare clinical symptoms such as intestinal obstruction, perforation or rupture, abscess and intestinal stula, etc., it is reported that GIST with the above-mentioned symptoms usually has a tumor diameter greater than 5 cm, even greater than 10 cm [6,7]. And necrosis of small intestine GIST is generally central liquefaction necrosis [8]; Therefore, it is considered that in ammation stimulus and perforation accompanied with formation of abscess cavity after injury, and speculated that the chronic in ammation of the tumor edge is caused by infection caused by trauma. HE staining of postoperative sections showed tumor cells ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Long-term Inflammatory Stimulation Caused by Trauma May Lead to Jejunum Intestinal Stromal Tumor: A Case Report

Zhou¹,

Li²,

Kong³

2020

Preprint

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Background: Gastrointestinal stromal tumor (GIST) is the most common stromal tumor of the gastrointestinal tract and it is considered to be an aggressive tumor with potentially malignant tendency. GIST is a tumor derived from mesenchymal tissue of the gastrointestinal tract or rarely of intraperitoneal soft tissue. Stem cajal cells from the muscular layer of the digestive tract are the precursor cells of GIST, which are pacemaker cells that cause the intestinal peristalsis and contract. The etiology of GIST is mainly caused by mutations in the KIT or PDGFRA oncogene. Although some papers reported that inflammation can cause tumor formation, it has not been reported that inflammation can cause GIST formation.Case presentation: A 64-year-old male patient was evaluated for recurrent dull pain and discomfort in the left upper abdomen. He had a history of abdominal trauma approximately six years prior. During this period, abdominal pain and fever were intermittent recurrent attacked. Intraoperative jejunum tumors were found to have inflammatory packages. Postoperative pathological examinations showed that the tumor envelope was intact and a large amount of inflammatory cells were seen around the tumor cells. Histopathology of the resected masses was positive for CD117 and Dog-1, and the patient was diagnosed as jejunum GIST.Conclusion: We reported a case of gastrointestinal stromal tumor that may be caused by repeated stimulation of chronic inflammation that caused by trauma. Early detection and timely removal of the inducement of repeated chronic inflammation can effectively prevent the occurrence of GIST.

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“…In a large series of 906 patients published by Miettinen et al ,28 jejunal and ileal GISTs most commonly presented with GI bleeding or an acute abdomen. In a recent paper by Xing et al ,29 GIST symptoms at presentation were evaluated in 197 patients on the basis of their location in the small bowel. Cardinal symptoms for patients with ileal GISTs included epigastric discomfort (38.3%), abdominal mass (34%), incidental finding (27.7%) and GI bleeding (12.8%).…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal stromal tumour (GIST) presenting as a strangulated inguinal hernia with small bowel obstruction

et al. 2017

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Gastrointestinal stromal tumours (GISTs) can arise everywhere along the gastrointestinal (GI) tract. Their presentation in unusual locations should always be taken into account. A 74-year-old man referred to the emergency department for small bowel obstruction caused by an incarcerated inguinal hernia. A CT scan showed a mesenchymal tumour originating from the herniated bowel loop and a mass in the ascending colon. Laparoscopic resection of the mass and laparoscopic right hemicolectomy were performed. The histology showed a ruptured GIST arising from the herniated small bowel and a high-grade dysplasia villous adenoma of the right colon. GISTs can present with symptoms spanning from vague abdominal discomfort to surgical urgencies. Strangulated hernia is an extremely rare presentation, with only two cases described in the literature. A safe surgical approach was obtained with laparoscopy, maintaining surgical radicality. The ileal localisation and the pseudocapsule rupture were the main risk factors on prognostic stratification.

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Small Bowel Stromal Tumors: Different Clinicopathologic and Computed Tomography Features in Various Anatomic Sites

Cited by 26 publications

References 26 publications

Small bowel gastrointestinal stromal tumor: a retrospective study of 32 cases at a single center and review of the literature

Small bowel gastrointestinal stromal tumor: a retrospective study of 32 cases at a single center and review of the literature

Long-term Inflammatory Stimulation Caused by Trauma May Lead to Jejunum Intestinal Stromal Tumor: A Case Report

Gastrointestinal stromal tumour (GIST) presenting as a strangulated inguinal hernia with small bowel obstruction

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