Gastrointestinal stromal tumours (GIST)

Abstract

Background-aim Gastrointestinal stromal tumours (GIST) are the most common mesenchymal neoplasms of the gastrointestinal tract, yet extremely rare since they account for less than 1% of all GI tumours, which may arise virtually in any part of the gastrointestinal tract. GISTs are typically defined as a group of heterogeneous gastrointestinal mesenchymal neoplasms that are characterized by the expression of c-KIT receptor tyrosine kinase (called CD117 antigen) and often also the CD34 antigen. There is an equal gender distribution, with a peak incidence between the fifth and sixth decade of life. Twenty percent of GISTs are asymptomatic. Clinical symptoms are non-specific including abdominal pain, ileus and weight loss, while the most common symptom at presentation is GI bleeding. Due to the non-specific presenting symptoms, diagnosis of GIST is often delayed. Useful diagnostic tools include imaging, endoscopy and histological examinations. GISTs are prone to metastasize. Prognostic factors include tumour size, mitotic activity and tumour location. The optimal treatment is radical surgery, while treatment with tyrosine kinase inhibitor imatinib has significantly improved the outcome of the disease. In the current study, we present five cases of GISTs treated in our department during the period 2007–2009, followed by a brief review of the literature.