Gastrointestinal Stromal Tumors

GASTROINTESTINAL STROMAL TUMORS


GASTROINTESTINAL STROMAL TUMORS (GIST)

  • Most common mesenchymal tumor of the abdomen
  • Commonly occur in stomach (mc site) and duodenum
  • Arise from the interstitial cells of Cajal or pacemaker cells
  • Carney triad (non hereditary syndrome of young females)
    • Gastric GIST
    • Paraganglioma
    • Pulmonary chondroma
  • Bleeding is the most common presentation (Endoscopy — appearance of cervix)
  • Diagnosis of malignancy is by greater mitotic figures
  • If mucosa is not ulcerated — biopsy on a biopsy is needed
  • Immunohistochemistry is mandatory for diagnosis. C-kit gene amplification — tumor marker
  • Size and mitotic index are the best predictors of metastasis
  • Peritoneal and liver metastases are most common
  • Lymphatic spread extremely rare
  • 80% tumors respond to Imatinib(tyrosine kinase antagonist)
  • Treatment of choice — Resection

Exam Important

  • Tyrosine kinase inhibitors imatinib and sunitinib are approved for the treatment of Gastrointestinal Stromal Tumors (GIST)
Don’t Forget to Solve all the previous Year Question asked on GASTROINTESTINAL STROMAL TUMORS (GIST)

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