CT Imaging in Gastrointestinal Stromal Tumour: A Case Series

Abstract

Gastrointestinal Stromal Tumours (GISTs) being most common non-epithelial tumours comprise a bunch of non-epithelial smooth muscle, mesenchymal alimentary tract tumours, appearing from the interstitial cells of Cajal of varying malignancy which specify KIT protein-CD117, a stem cell factor receptor. The mutations seen in GIST’s are most common in the proto-oncogene c-KIT; seen only in GIST. This gene is not seen in the other mesenchyamal tumours. Here, the mutated c-KIT helps in the growth and survival of this tumour by activation of the KIT receptor tyrosine kinase. The incident of GISTs is increasing in recognition and the increased rate of survival has made imaging seemingly important, not only for diagnosis, but also for monitoring the effects of treatment and detecting progression of the tumour. The clinical symtoms in this case series include pain abdomen, nausea, vomiting and constipation. Some cases can present as abdominal distension. The investigation of choice for these spectrum of diseases is currently Computed Tomography (CT), however many imaging techniques, such as Positron Emission Tomography (PET), fluorine 18 Fluorode-Oxyglucose (FDG), Magnetic Resonance (MR) imaging, and Ultrasonography (US) can also be used. This article describes the typical imaging findings of GISTs at initial presentation. Many cases present late and at a stage where surgery will not be of much use. However, Imatinib has showed a drastic response in prognosis and helps increasing the survival changes leading a normal life. This study helps us in identifying the pattern of the lesion and its enhancement patterns leading to early detection, thus aiding the surgeon or the oncologist to plan for treatment.