title: [Difficulties in diagnosing and treating GIST: report and analysis of a case].
abstract: Gastrointestinal stromal tumours account for fewer than 1% of malignant tumours of the digestive system. Analysing a case referred to us for observation, we review the literature with regard to diagnostic and therapeutic difficulties. A 68-year-old patient was referred to our institute with a diagnosis of "retroperitoneal haematoma". Computerised tomography showed a solid mass with a liquid component, occupying almost the whole of the abdominal cavity. An ultrasonography-guided biopsy examination suggested the presence of a sarcoma. Exploratory laparotomy and the histological examination, which was positive for CD117, CD34 and the smooth muscle marker caldesmon, allowed a diagnosis of gastrointestinal stromal tumour to be made. Thus, no thoroughly reliable and accurate diagnosis of gastrointestinal tumour can be made without surgical exploration and consequent histological and immunohistochemical examinations that still represent the only method capable of confirming or ruling out a diagnosis of gastrointestinal stromal tumour. Such tumours are rare and aggressive and their prognosis is closely related to tumour size and the mitotic index per high power field. Radical resection affords the only possibility of long-term survival.
authors.affiliation: Istituto di Chirurgia Generale e Specialità Chirurgiche, Università degli Studi di Siena, Siena.
authors.forename: Walter
authors.initials: W
authors.lastname: Testi
authors.forename: Carmen
authors.initials: C
authors.lastname: Staffieri
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Consiglio
authors.forename: Alberto
authors.initials: A
authors.lastname: Genovese
authors.forename: Daniela
authors.initials: D
authors.lastname: Cirianni
authors.forename: Massimo
authors.initials: M
authors.lastname: Ranalli
authors.forename: Camilla
authors.initials: C
authors.lastname: Bing
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tumbiolo
mesh_terms: D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis*; D002148:Calmodulin-Binding Proteins / Q000032:analysis; D003937:Diagnosis, Differential; D046152:Gastrointestinal Stromal Tumors / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D011379:Prognosis; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D002148:Calmodulin-Binding Proteins; D019009:Proto-Oncogene Proteins c-kit