Gastro Intestinal Stromal Tumor: State of the Art through Our Experience of 64 Cases and a Literature Review

Abstract

Gastrointestinal stromal tumors are rare. They are a subject of controversy. We have reported 64 cases of gastrointestinal stromal tumor diagnosed in the surgery department of CHU Hassan II of FES between January 2014 and December 2018. The study involved 64 patients (34 men and 30 women) with an average age of 56. The circumstances of findings were dominated by abdominal pain (48 cases), vomiting 16 case followed by transit disorder with 9 cases. The tumor locations were mainly the stomach (n = 31), the small intestine (n = 28), the duodenum (n = 3), and the colon (n = 2). Ultrasound, endoscopy and CT were the main additional tests to detect tumor syndrome. 55 patients were treated by complete surgical excision. Tumor size ranged from 4cm to 18cm. Histologically, the spindle cell type was predominant in 88.91% of cases; epithelioid type was present in 7.81% of cases, while the mixed type was found in 3.6%. The analysis of the expression of CD 117 marker was present in 95.31%, while immunostaining with this marker returned negative in 3 cases; i.e. 5% whose c-kit was positive. Imatinib was indicated in 44 patients (63.60%), with 9 indications for metastatic tumor. As a neoadjuvant, imatinib was indicated in 5 patients, with remission in 28 patients (50.9%), stabilization in 4 patients (7.2%), 2 cases of tumor recurrence and 7 cases of death.