GIST (Gastrointestinal Stromal Tumor)
Rare mesenchymal tumors of the GI tract, most commonly found in the stomach.
Overview
Gastrointestinal Stromal Tumors (GISTs) are the most common mesenchymal tumors of the GI tract, arising from interstitial cells of Cajal. They commonly occur in the stomach (60%) and small intestine (30%). Treatment depends on size, mitotic rate, and location.
Causes
- KIT gene mutation (85%)
- PDGFRA gene mutation (5-10%)
- Succinate dehydrogenase (SDH) deficiency (pediatric/wild-type)
Risk Factors
- No known modifiable risk factors
- Familial GIST syndrome (very rare)
- Neurofibromatosis type 1
- Carney triad
Symptoms
Diagnosis
- CT abdomen with contrast
- Endoscopy with EUS-guided biopsy
- Immunohistochemistry (CD117/DOG1 positive)
- Mutation analysis (KIT/PDGFRA)
- PET-CT (for monitoring treatment response)
Treatment Options
Surgical Treatment
Complete surgical resection with negative margins is the primary treatment for localized GISTs. Unlike carcinomas, lymph node dissection is NOT needed (GISTs rarely metastasize to lymph nodes). Laparoscopic wedge resection is ideal for gastric GISTs. Imatinib (Gleevec) is used neoadjuvantly for borderline resectable tumors and adjuvantly for high-risk tumors.
Recovery
Gastric wedge resection: 3-5 days hospital stay. Adjuvant imatinib for 3 years if high-risk. Regular CT surveillance every 3-6 months. Excellent prognosis for completely resected tumors.
Prevention
- No known prevention
- Early evaluation of GI symptoms for early detection
Frequently Asked Questions
Is GIST cancer?
What is imatinib?
Expert Consultation Available
Get personalized treatment advice from Dr. Bhagat. Book an appointment or connect via WhatsApp for a quick consultation.