Gastrointestinal stromal tumor

Gastrointestinal stromal tumor (GIST): Description, Causes and Risk Factors: Abbreviation: GIST. GISTGISTs are a relatively uncommon type of cancer that occurs in the GI tract (gastrointestinal tract). GISTs are believed to start in special cells found in the wall of the GI tract, called the interstitial cells of Cajals (ICCs), or in very early cells that can develop into ICCs. ICCs are part of the autonomic nervous system, which sends signals to the GI tract. Some have called these cells the "pacemakers" of the GI tract. The nerve signals they send cause muscles of the digestive organs to contract, which helps to move food and liquid through the GI tract. Although these tumors can start anywhere in the GI tract, they occur most often in the stomach. Occurrence: Stomach 50-60%.
  • Small bowel 20-30%.
  • Large bowel 10%.
  • Esophagus 5%.
  • Else where in abdomen 5%.
The exact cause of GIST is unknown. However, we do know that there is a change in an oncogene called c-kit (CD117) of almost all patients with GIST. The c-kit gene is found in all cells of the body. It leads to the formation of a protein called KIT. The disease is thought to be predominantly caused by a mutation or change in an enzyme called KIT (CD117), which is found on the surface of normal cells. In healthy individuals, the role of KIT is to signal cells to grow and divide. However, in patients with GIST, a malfunctioning KIT signals the cells to constantly grow and divide out of control, and they become cancerous. In some GISTs, a different gene mutation causes the cell to make too much of a protein called PDGFRA (platelet-derived growth factor receptor, alpha polypeptide). This has the same effect on the cell as does KIT. Experts believe that in the U.S., as many as 4,500 to 6,000 new cases of GIST occur each year. Symptoms: Abdominal pain. Diagnosis: The tests which helps to determine whether patients have a tumor or tumors, where the tumor ortumors are located, how big they are, and whether or not the cancer has spread outside of the GI include Laparoscopy.
  • Colonoscopy.
  • Upper endoscopy.
  • Barium X-rays.
  • Ultrasound.
  • CT or CAT scan.
  • MRI.
  • PET (positron emission tomography).
If a tumor is present, a tissue sample, or biopsy, is needed for the doctor to determine whetherit is malignant or benign. The pathologist will test the tumor sample for the presence of KIT/CD117. Treatment: Factors to consider in decision making. Patient individual risk profile (using established risk assessment approach).
  • Patient individual risk tolerance.
  • Relative importance of RFS and OS for individual patient and society in general.
Surgery is the principal treatment and only curative therapy for localized, resectable primary disease. Some patients present with locally advanced disease or localized disease that can only be resected by function compromising surgery. Imatinib is the first-line treatment in patients with metastatic or unresectable GIST. Imatinib response rate is 50-60 %, decreased vascularity even in SD. Neoadjuvant treatment may result in clinically significant down staging of the primary tumor. Surgery in metastatic disease only after multidisciplinary consideration, at experienced centers, with careful patient discussion. Disclaimer:The above information is general information (informational purpose only, sometimes may not be accurate). The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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