Gastrointestinal Stromal Tumor

Abstract

Gastrointestinal stromal tumors (GISTs) are a rare soft tissue sarcomas arising from gut pacemaker of mesenchymal stem cell origin, interstitial cell of Cajal. It may be benign or malignant. The most common site of origin is in the stomach, followed by small intestine, colon and rectum, oesophagus, mesentery, omentum, retroperitoneum and pelvis. Biological behaviour depends on tumor size and mitotic index. Diagnosis is delayed due to vague clinical features. Most of the recent investigations are not conclusive. Conventional histopathology could not differentiate it from leiomyoma or leiomyosarcoma. Only immunohistochemical staining by CD117 is confirmatory for diagnosis. Conventional chemotherapy is not effective but imatinib mesylate, a tyrosine kinase inhibitor, and sunitinib, a multikinase inhibitor are effective for adjuvant or neoadjuvant therapy. Surgery is the definitive therapy for the patients with GISTs. Radical surgical extirpation offers the only chance for cure.

DOI: 10.3329/taj.v22i1.5042

TAJ 2009; 22(1): 156-160