Gastrointestinal stromal tumours: a clinico-pathological study
- Author:
Hla OO
1
;
Pemasari Upali TELISINGHE,
1
;
Ghazala KAFEEL
1
;
Prathibha Parampalli SUBRHAMANYA
1
;
Sowmya Tatti RAJARAM
1
Author Information
1. Department of Pathology, RIPAS Hospital Bandar Seri Begawan, Brunei Darussalam
- Publication Type:Journal Article
- Keywords:
Immunohistochemistry;
interstitial cells of Cajal;
leiomyosarcoma;
proto-oncogene protein C-KIT
- From:
Brunei International Medical Journal
2011;7(6):314-320
- CountryBrunei Darussalam
- Language:English
-
Abstract:
Introduction:: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. Histologically, it can be categorised into spindle cell, epithelioid cell or mixed spindle and epithelioid types. This study assesses the clinico-pathological features of GISTs encountered in Brunei Darussalam.
Material and Methods:: The Department of Pathology registry from 1999 to 2009 was reviewed for cases of GISTs.
Results: : There were 594 cases of gastrointestinal malignancies encountered during this period and GISTs accounted for 4.5% (n=27). Men and women were equally affected and the ethnic breakdown consisted of Malay (70.4%), Chinese (14.8%), Filipino (11%) and other races (3.7%). The clinical presentations were abdominal pain/mass (51%), upper gastrointestinal bleeds/melaena (30%), dyspepsia/vomiting (11%) and anaemia (4%). One patient (4%) had GISTs as an incidental finding on imaging study for other indication. The tumours were located in the stomach (59.3%), small intestine (33.3%) and one case each involving the colon/rectum (3.7%) and omentum (3.7%). The majority occurred between the fourth and seventh decade (range 16 to 83 years). Histologically, 66.7% were categorised as spindle cell, 18.5% epithelioid and 14.8% mixed cell types. On immunohistochemistry studies, 59% were positive for C-KIT (CD117), 66% for CD34, 48% co-expressed CD117 and CD34, 70% for Smooth Muscle Actin (SMA), 41% for S100 protein, 81% for Vimentin and 26% for Desmin. Based on tumour size and mitotic count, 3.7% was categorised as very low, 7.4% as low, 11% as intermediate and 77.8% high risk respectively.
Conclusion:: GISTs accounted for 4.5% of all GI malignancies and more than 70% were categorised as high risk.
Accurate diagnosis is important as complete surgical resection is currently the first-line of therapy for
resectable tumours. For unresectable disease targeted therapy with tyrosine kinase inhibitors is an
option.
- Full text:2026070710552232834314-20.pdf
