Gastrointestinal Stromal Tumors: Experience from a Single Surgical Unit

Background: Gastrointestinal stromal tumors (GISTs) are rare tumors, but comprise the most common mesenchymal neoplasms of the gastrointestinal (GI) tract. We report a clinical series of abdominal GIST and discuss the diagnosis and management in Indian patients.
Case Series: The data on demographic profile, clinical presentation and management of 12 cases of GIST from a single surgical unit in the last seven years were studied retrospectively. Preoperatively, ultrasonographic and computerized tomographic scans of the abdomen were the main investigations used for evaluation; the others being upper gastrointestinal endoscopy and X-ray of the chest. Histopathological examination and immunohistochemical evaluation were used to confirm the diagnosis.
Results: The mean age at presentation was 47.9 years (range 35 – 70 years). Mean duration of symptoms was of 5 months (range 10 days–2 years). While all 12 patients presented with abdominal pain, 10 complained of abdominal lump. Two patients complained of vomiting and 1 of upper GI bleed. All patients were operated. In 7 cases, the GIST was arising from the ileum, 3 from the stomach and 2 from the mesentery. Nine cases had low grade benign tumors and 3 had malignancy.
Conclusion: Abdominal pain and lump are the most common clinical symptoms of abdominal GIST. Vomiting, upper GI bleeding and weight loss are among the other important symptoms. Most of the tumors are benign and surgical resection remains the mainstay of treatment.