Gastrointestinal Stromal Tumor (GIST) is uncommon disease with only about 3,000 to 6,000 cases diagnosed annually. Tumors can occur in any sites in gastrointestinal tract, especially in stomach (60-70%) and small intestine (20-30%) and in large intestine and oesophagus, sometime in omentum, mesenterium, behind peritonaeum, etc. The disease is common in male from 40 to 80 years old. GIST is detected randomly during examinations such as endoscopy, X-ray or CT scan of stomach, large intestine. Tumors have two kinds of cell: lozenge cell (70%) and epithelial cell (30%). GIST is divided into 4 stages. Each stage has suitable treatments as chemical therapy, radio therapy, and targeted therapy. For metastatic GIST, tumors can be removed by surgery. The 5 years survival rate is 34% in removal tumors and is 10% in remained tumors
Gastrointestinal Stromal Tumors ; Diagnosis

No abstract available.
Gastrointestinal Stromal Tumors/*diagnosis ; Humans

Gastrointestinal stomal tumor is a rare mesenchymal tumor of the gastrointestinal tract. Stomach and small intestine are the most common sites. Tumors originate from interstitial cells of Cajal. The preoperative and intraoperative diagnosis is usually difficult. It is necessary to base on immunohistochemical staining with antibody CD117 for definitive diagnosis. Tumor may be benign or malignant. Surgery is the first choice, and can be associated with targeted therapy, a competitive inhibitor of specific tyrosine kinase. Postoperative recurrence is rare and commonly has no complication. It is necessary to follow up by CT scan every 6 months in the first 2 years and then every 3 years
Gastrointestinal Stromal Tumors ; Diagnosis ; Case Reports

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract. At present, many professional academic groups and associations at home and abroad have released guidelines for the diagnosis and treatment of GIST. In 2020, Gastrointestinal Stromal Tumor Expert Committee of China Society of Clinical Oncology (CSCO) issued the first "CSCO gastrointestinal stromal tumor diagnosis and treatment guidelines" in China. In the same year, NCCN also released the first "NCCN guideline for the diagnosis and treatment of gastrointestinal stromal tumors (first edition in 2021)" by separating GIST-related content from the guideline for soft tissue sarcoma. However, there are many inconsistencies between the guidelines' recommendation and clinical practice in China. For example, in the aspect of diagnosis, the emphasis on and implementation of molecular detection are variable, the format of molecular detection report is not unified or standardized, the selection of detection methods is inappropriate, the diagnosis of wild-type GIST is not standardized, the risk assessment is improper, and the use of EUS-FNA is relatively seldom; in the aspect of drug therapy, there are some problems, such as the lack of standardization in dose and course of targeted drugs, and off-label medication such as cross line therapy; in terms of surgical treatment, there are also some problems, such as the clinical application scenarios of laparoscopic surgery exceed the recommendations of the guidelines, and the general description of surgical intervention of advanced GIST in the guidelines cannot well guide specific clinical practice. In this context, on the one hand, clinicians need to understand the academic frontier and standardize their medical behavior with the latest guidelines; on the other hand, clinicians need to consider the scientific rationale and accessibility of treatment on some clinical problems that are not clear in the guidelines, and take whether patients can benefit the most as the criteria.
China ; Gastrointestinal Stromal Tumors/diagnosis* ; Humans

PURPOSE: Endoscopic ultrasonography (EUS) is a useful imaging procedure for the diagnosis of submucosal tumors in the stomach. The present study investigated the EUS features of benign and malignant gastrointestinal stromal tumors (GISTs) and assessed differences between the two groups. MATERIALS AND METHODS: Thirty patients with a GIST in the stomach were included in the study (23 benign and 7 malignant GISTs). We compared characteristic EUS findings (tumor size, location of tumor, regularity of the outer margin, echo-heterogeneity, presence of cystic spaces, echogenic foci and mucosal ulceration) between benign and malignant GISTs. RESULTS: Tumor sizes over 40 mm were observed in 85.7% of the malignant and 8.7% of the benign tumors (P=0.000). Intralesional cystic spaces were noted in 71.4% of the malignant and 8.7% of the benign tumors (P=0.003). The outer margin was irregular in 71.4% of the malignant and 8.7% of the benign tumors (P=0.014). 85.7% of the malignant and 13.0% of the benign tumors had an echo-heterogeneity in the tumor (P=0.001). The locations of tumor and the presence of echogenic foci or mucosal ulcerations were not different between the two groups. CONCLUSION: Tumor sizes over 40 mm, intralesional cystic spaces, irregular outer margins, and echo-heterogeneity in the tumor were significantly more frequent in malignant GISTs. EUS can provide informations in differentiating benign from malignant GISTs.
Diagnosis* ; Endosonography* ; Gastrointestinal Stromal Tumors* ; Humans ; Stomach* ; Ulcer

PURPOSE: Endoscopic ultrasonography (EUS) is a useful imaging procedure for the diagnosis of submucosal tumors in the stomach. The present study investigated the EUS features of benign and malignant gastrointestinal stromal tumors (GISTs) and assessed differences between the two groups. MATERIALS AND METHODS: Thirty patients with a GIST in the stomach were included in the study (23 benign and 7 malignant GISTs). We compared characteristic EUS findings (tumor size, location of tumor, regularity of the outer margin, echo-heterogeneity, presence of cystic spaces, echogenic foci and mucosal ulceration) between benign and malignant GISTs. RESULTS: Tumor sizes over 40 mm were observed in 85.7% of the malignant and 8.7% of the benign tumors (P=0.000). Intralesional cystic spaces were noted in 71.4% of the malignant and 8.7% of the benign tumors (P=0.003). The outer margin was irregular in 71.4% of the malignant and 8.7% of the benign tumors (P=0.014). 85.7% of the malignant and 13.0% of the benign tumors had an echo-heterogeneity in the tumor (P=0.001). The locations of tumor and the presence of echogenic foci or mucosal ulcerations were not different between the two groups. CONCLUSION: Tumor sizes over 40 mm, intralesional cystic spaces, irregular outer margins, and echo-heterogeneity in the tumor were significantly more frequent in malignant GISTs. EUS can provide informations in differentiating benign from malignant GISTs.
Diagnosis* ; Endosonography* ; Gastrointestinal Stromal Tumors* ; Humans ; Stomach* ; Ulcer

Sarcomatoid carcinoma is a rare neoplasm of epithelial origin but consists partly of variable differentiated tumor cells of mesenchymal origin. Accurate diagnosis, including differentiation from adenocarcinoma or gastrointestinal stromal tumor, is difficult. We experienced three cases of sarcomatoid carcinoma of the stomach, and describe the radiological and pathologic findings. One case involved a polypoid mass in the antrum, another a mass with a large ulcer mimicking a Bormann type-II adenocarcinoma in the body, while in the third case, an intraluminal bulky mass arising from the cardia of the stomach was present. This was not differentiated from cancer or stromal tumor.
Adenocarcinoma ; Cardia ; Diagnosis ; Gastrointestinal Stromal Tumors ; Stomach* ; Ulcer

Gastrointestinal Stromal Tumors ; diagnosis ; epidemiology ; surgery ; Humans ; Stomach ; pathology

The histologic analysis of gastrointestinal stromal tumors (GISTs) is a common method to detect the mitotic activity and to subsequently determine the risk of GISTs for malignancy. The potential false negative error due to inadequate yield of specimens and actual determination of malignancy risk requires analysis of the whole tumor. We aimed to assess the role of contrast enhanced endoscopic ultrasound (CE-EUS) in the management of GISTs. Two authors individually did review of English literatures to identify nine peer-reviewed original articles using keywords- contrast endoscopic ultrasound, GIST and submucosal tumor. Studies were heterogeneous in their aims looking either at differentiating submucosal lesions from GISTs, estimating malignant potential of GISTs with histologic correlation or studying the role of angiogenesis in malignant risk stratification. CE-EUS had moderate to high efficacy in differentiating GISTs from alternative submucosal tumors. CE-EUS had a higher sensitivity than EUS-guided fine needle aspiration, contrast computed tomography and Doppler EUS for detection of neo-vascularity within the GISTs. However, the evidence of abnormal angiogenesis within GIST as a prognostic factor needs further validation. CE-EUS is a non-invasive modality, which can help differentiate GISTs and provide valuable assessment of their perfusion patterns to allow better prediction of their malignant potential but more experience is needed.
Biopsy, Fine-Needle ; Diagnosis* ; Gastrointestinal Stromal Tumors* ; Methods ; Perfusion ; Ultrasonography*

BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) is the most efficient imaging modality for gastric subepithelial tumors (SETs). However, abdominopelvic computed tomography (APCT) has other advantages in evaluating the characteristics, local extension, or invasion of SETs to adjacent organs. This study aimed to compare the diagnostic ability of EUS and APCT based on surgical histopathology results.METHODS: We retrospectively reviewed data from 53 patients who underwent both EUS and APCT before laparoscopic wedge resection for gastric SETs from January 2010 to December 2017 at a single institution. On the basis of histopathology results, we assessed the diagnostic ability of the 2 tests.RESULTS: The overall accuracy of EUS and APCT was 64.2% and 50.9%, respectively. In particular, the accuracy of EUS vs. APCT for the diagnosis of gastrointestinal stromal tumors (GISTs), leiomyomas, and ectopic pancreas was 83.9% vs. 74.2%, 37.5% vs. 0.0%, and 57.1% vs. 14.3%, respectively. Most of the incorrect diagnoses with EUS involved hypoechoic lesions originating in the fourth echolayer, with the most common misdiagnosed lesions being GISTs mistaken for leiomyomas and vice versa.CONCLUSIONS: APCT showed a lower overall accuracy than EUS; however, APCT remains a useful modality for malignant/potentially malignant gastric SETs.
Diagnosis ; Endosonography ; Gastrointestinal Stromal Tumors ; Humans ; Leiomyoma ; Pancreas ; Retrospective Studies