Title: Gastrointestinal Stromal Tumors –A case series –Our Experience Over Four Years in A Tertiary Care Medical College Hospital
Authors: Sreeramulu PN, Prakash Dave, Vikranth SN, Karthik Hareen TVK, Suma S
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.184
Abstract
Background: Gastrointestinal stromal tumors (GIST) are mesenchymal tumors and account for 3% of all gastrointestinal malignancies. They are unpredictable, rare, enigmatic and display aggressive behavior1. They express tyrosine kinase (KIT) and commonly involve small gut and stomach (rarely esophagus, mesentery and colon). A series of 11 cases of GIST managed in a teaching hospital attached to a medical college over 4 years is presented.
Methods: Medical records of the 11 cases of GIST managed during January 2013 through December 2016 were reviewed for patient demographics, clinical presentation, investigation, sites, treatment, histology, immunohistochemistry and Imatinib therapy. Follow up for recurrence over the period ranging from 6 months to 4 years was done.
Results: GIST was common in men. Age ranged 28 to 75 years. Sites involved were--small bowel in 5, stomach in 2, mesentery in 2, rectum and greater omentum 1 each. Symptoms ranged from abdominal pain, mass, upper /lower gastrointestinal bleeding, small bowel obstruction. Surgery was the mainstay of the treatment. All were positive for tyrosine kinase. One case was non resectable and another showed metastasis to the mesenteric lymph nodes, which is uncommon. All received Imatinib post operatively. Recurrence was seen in one patient with small bowel GIST at 2 years.
Conclusions: GIST are uncommon with varied presentations and may be aggressive and can recur. GIST tumors elaborate tyrosine kinase, hence KIT receptor inhibitor Imatinib was useful in all, nonresectable & recurrent tumors. Tyrosine kinase inhibitor has thus drastically changed the diagnosis and management of these tumors.
Keywords: Gastrointestinal Stromal Tumors;Imatinib Mesylate; Tyrosine Kinase.
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