[Difficulties in diagnosing and treating GIST: report and analysis of a case].
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.
Testi
Walter
W
Istituto di Chirurgia Generale e Specialità Chirurgiche, Università degli Studi di Siena, Siena.
Staffieri
Carmen
C
Consiglio
Francesco Maria
FM
Genovese
Alberto
A
Cirianni
Daniela
D
Ranalli
Massimo
M
Bing
Camilla
C
Tumbiolo
Salvatore
S
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
D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D002148:Calmodulin-Binding Proteins; D019009:Proto-Oncogene Proteins c-kit