Gastrointestinal stromal tumors arising from the stomach: a report of three children.
BACKGROUND
Gastrointestinal stromal tumors (GIST) are a unique subset of intestinal mesenchymal tumors that behave in an aggressive fashion. They have been commonly described in adults but have been rarely observed in children.


METHODS
The authors review the presentation, diagnostic workup, operative records, pathologic specimens, and outcomes of 3 children with GISTs that originated from the stomach.


RESULTS
All 3 children presented after upper gastrointestinal bleeding from the gastric tumor. The first was a 10-year-old girl who underwent partial gastrectomy but had recurrence 8 years later requiring a second resection. She subsequently had a hepatic metastasis 8 years later requiring a third resection. The second patient was a 9-year-old girl who had an antrectomy with a Bilroth I reconstruction and was noted to have a synchronous liver metastasis that was also resected. Despite Imatinib Mesylate, she had further hepatic metastases. The third child was a 4-year-old boy who recently underwent a partial gastrectomy and has no signs of metastatic disease at this time.


CONCLUSIONS
GISTs are unusual tumors that have been rarely described in children. When they arise in the stomach, they often present after upper gastrointestinal bleeding. Diagnosis can be made by endoscopy and biopsy. GISTs require resection and close observation for hepatic metastases. Current studies are ongoing for the potential role of Imatinib Mesylate for GISTs in children.
Department of Surgery, Children's Healthcare of Atlanta at Egleston and Emory University, Atlanta, GA 30322, USA.
Megan M
MM
Durham
Kenneth W
KW
Gow
Bahig M
BM
Shehata
Howard M
HM
Katzenstein
Robert L
RL
Lorenzo
Richard R
RR
Ricketts
D015746:Abdominal Pain / Q000209:etiology; D000740:Anemia / Q000209:etiology; D001549:Benzamides; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D000068877:Imatinib Mesylate; D007813:Laparotomy; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery; D008297:Male; D010879:Piperazines / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D011859:Radiography; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*
D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate