Tag Archives: gastrointestinal stromal tumors

Uncommon Finding of a Gastrointestinal Stromal Tumor in a Patient with Hyperechoic Liver Lesions – Case Report

DOI: 10.2478/amma-2018-0026

Introduction: Hyperechoic liver lesions identified by conventional ultrasonography are diverse in underlying pathology and most of the time require further investigations. Gastrointestinal stromal tumors (GIST) are rare neoplasms of the gastrointestinal tract which are uncommonly found in metastatic stages at first presentation.
Case report: We present the case of a 51 years old woman with nonspecific symptoms in which conventional ultrasonography showed hyperechoic lesions in the right lobe of the liver with a diameter up to 40 mm. Esophagogastroduodenoscopy revealed a submucosal tumor on the small curvature of the stomach, on the anterior wall, with central ulceration, with normal narrow band imaging (NBI) mucosal pattern and negative gastric biopsy. Contrast enhanced ultrasonography was performed, describing multiple lesions with inhomogeneous enhancement in the arterial phase and rapid washout at the end of arterial phase. Endoscopic ultrasound with fine needle aspiration (EUS-FNA) biopsy examination was definitive for the final diagnosis of epithelioid gastric gastrointestinal stromal tumor. The patient was diagnosed with T2N0M1 epithelioid gastric GIST, stage IV, and is currently under treatment with tyrosine kinase inhibitors.
Conclusions: GIST represent a diagnostic challenge in medical practice because of its size, unusual location in the submucosal layer and lack of symptoms. The role of EUS-FNA is of paramount importance in increasing the accuracy of diagnosis in the case of GIST. The particularity in our case consists of the unusual presentation with the lack of specific symptoms and signs associated with the presence of metastatic lesions at the moment of the diagnosis of GIST.

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Surgical Risk Factors of Patients with Operable Gist

DOI: 10.1515/amma-2015-0031

Introduction: Gastrointestinal stromal tumors (GIST) are the most frequently mezenchimale tumors of the gastrointestinal tract. This study aims to analyze the results after surgical treatment of GIST and identify key risk factors influencing postoperative course of these patients in order to discover the most effective therapeutic methods to significantly improve postoperative course of these patients.
Methods: We retrospectively reviewed the medical records of all patients who underwent surgical removal of GISTs from 2004-2014. Patient demographics, criterion for admission, surgery, complications, secondary dissemination, histopathological data and clinical course were analized following patient survival at 12, 24, 36 and to 60 months postoperatively. Statistical analysis was performed using the MedCalc software program, and survival analysis was done by Kaplan Meyer.
Results: During this period we analyzed a total of 28 cases, including 13 males and 15 females with age from 33 to 80 years (median, 61). The tumor was located in the stomach (15 cases; 53%), small intestine in ten cases (36%) and other sites in three patients ( 11%). Multivariate analysis revealed that tumor size (P <0,05), criterion for admission (P<0,05) and secondary dissemination (P<0,05) are independed prognostic factors.
Conclusions: Factors like: age and sex of patients, size and tumor site, presence or absence of metastasis, are prognostic risk factors with significant differences in the evolution of patients with operable GIST. The small number of patients and retrospective nature of the study have created difficulties in the estimation where we concluded the need of a prospective multicentric study.

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