Gastrointestinal Stromal Tumors: Diagnostic and Therapeutic ChallengesIbrahim Abdelkader Salama1*, Waleed Hammam Mosa2, Mohamed Elsherbini3, Mohamed Abbasy4 Mohamed Houseni5 and Mohamed Badr6
- *Corresponding Author:
- Ibrahim Abdelkader Salama M.D
Department of Hepatobiliary Surgery
National Liver Institute, Menophyia University
Shiben Elkom, Egypt
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E-mail: [email protected]
Received Date: June 25, 2014 ; Accepted Date: August 25, 2014; Published Date: September 20, 2014
Citation: Salama IA, Mosa WH, Elsherbini M, Abbasy M, Houseni M, et al. Gastrointestinal Stromal Tumors: Diagnostic and Therapeutic Challenges. Journal of Surgery [Jurnalul de chirurgie] 2014; 10(2):146-152 doi: 10.7438/1584-9341-10-2-11
Copyright: © 2014 Salama IA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasms of the digestive system. They originate from the interstitial cells of Cajal and are characterized by the over expression of KIT protein (Tyrosine Kinase), and they pose a diagnostic and therapeutic dilemma.
Objective: A challenge in diagnosis and treatment of GIST
Patients & Methods: This is a retrospective study of GIST cases that diagnosed and treated in our center during the past 5 years. These studies include clinical characteristics, imaging techniques, neoadjuvant therapy, surgical techniques, immunohistochemistry, and prognosis of such cases. Results: Sixteen patients were diagnosed as having GIST (12 males/4 females) with a mean age 62 years (31-83 years). Diagnosis was made preoperatively in 11 patients (69%) and intraoperatively with histopatholgical confirmation in five patients (31%). The site of the tumor was detected in the stomach in 6 cases (37.5%), one in duodenum (6.25%), five in small intestine (31.25%), one in mesentery (6.25%), two in colon (12.5%) and one rectal GIST (6.25%). The main presentation of the disease was anemia, GIT bleeding and abdominal mass. Fourteen patients considered resectable and they were operated upon (87.5%) and in two patients (12.5%) neadjuvant therapy was started with favorable response in one case and poor response in other one with advanced GIST. All patients received Imatinib as adjuvant therapy. Mean follow up period was 33 months (4-54 months).
Conclusion: GIST is a complex and challenging disease that requires a multidisciplinary approach in specililized center for better prognosis of such disease.