Gastro-Intestinal Stromal Tumors (GISTs) Diagnosis and Management at Al-Yarmouk Teaching Hospital

Abstract

ABSTRACT
Background: Gastrointestinal stromal tumors (GISTs) are the most common
mesenchymal neoplasms of the gastrointestinal tract. These lesions were previously
classified as leiomyomas and leiomyosarcomas. GISTs are generally CD117 positive.
The widespread use of this test resulted in increased awareness of the disease.
Objectives: To study the pattern of GIST disease at Al-Yarmouk Teaching Hospital and to
study its surgical management and results of the pathological studies.
Methods: During a three years period, 13 patients were positively diagnosed with GIST.
All relevant demographic and clinical data were studied retrospectively. All the results of
investigations and imaging studies were documented. The surgical findings and
procedures were recorded in detail. The results of histopathology and
immunohistochemical tests were reviewed.
Results: Of 13 patients, 8 were females and 5 males. The mean age was 54 years.
Patients presented mainly as abdominal pain (23.5%) or lower gastrointestinal bleeding
(23.5%). The best investigation was CT scan which revealed mainly bowel-related or
mesenteric mass. Surgery was elective in 10 patients and as an emergency in three
patients. Histopathologic examination showed GIST-like lesions and this was confirmed by
positive test for CD117.
Conclusions: GISTs present clinically with features of gastric or small intestinal tumors.
The presence of the tumor can be confirmed by ultrasonography and CT-scan. The
management is surgical. The final confirmation of the disease is by immunohistochemical
studies. The tumor is still relatively rare compared to other GI malignancies.