TITLE:
Complexity of Giant GIST Case Series and Review of the Literature
AUTHORS:
Remy Mckey, Mohamad Alskafi, Houda Khatoun, Hassan Salame, Salah Ezzedine
KEYWORDS:
Gastrointestinal Stromal Tumor, GIST, GI Malignancy, Imatinib, Case Series
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.12 No.6,
June
30,
2022
ABSTRACT: Background: Gastrointestinal stromal tumors are the most common type of mesenchymal
tumors of the GI tract, most commonly found in the stomach and intestines. They
are thought to grow from the interstitial cells of Cajal (ICCs) or precursors
of these cells. They have an insidious onset and may grow to a very large size
depending on the site of origin. Material and method: We present
a case series of three patients who had very large GISTs that had different
presentations and outcomes. Patients were from different backgrounds and all were
above 50 years old. Each one had a palpable mass in the abdomen in the initial
presentation with a multilobulated mass at imaging devoting malignant behavior
and higher risk of the tumor. They are managed according to guidelines and
treated with Imatinib, but none of them had genetic and molecular studies of
the tumor due to non-availability of the test. Conclusion: As a
conclusion, GISTs are not easy to diagnose especially in the early phase of the
disease and it may take years for it to become clinically relevant. Thence a
thorough medical history and physical exam with imaging and endoscopies are the
main diagnostic modalities with the importance of molecular profiling that will
guide therapy and predicting prognosis.