title: Gastrointestinal stromal tumors: clinical pathological review of a personal series.
abstract: The Authors report their experience on the management of gastrointestinal stromal tumors (GISTs). In addition to recent cases immediately diagnosed as GISTs, a pathological review of stored material from non-epithelial tumors of the gastrointestinal tract operated on over the past 20 years was performed. Twenty-three out of a total of 31 cases were shown to be positive for the immunophenotypic characteristics (CD117/CD34) of GISTs. Most cases (approximately 60%) were symptomatic, with hemorrhage being the most common presenting sign, followed by occlusion, pain and perforation. Asymptomatic cases were detected incidentally during procedures for other conditions. Diagnostic techniques (ultrasound, endoscopy, endoscopic ultrasound, X-ray, CT, MRI) allowed only the detection of wall (extraluminal) involvement. Apart from differentiating between benign and malignant, preoperative biopsy was seldom valuable. All cases were treated surgically, with intervention tailored to location and anatomical/surgical and anatomical/pathological features. Long-term follow-up was conducted in all patients and for most is still ongoing: five patients died from recurrent disease at varying intervals after surgery (from 17 to 102 months). Relationships between observed aggressiveness and risk were studied. Parameters that may prove useful for the early detection and appropriate management of these lesions are discussed.
authors.affiliation: DICMI - Dipartimento Discipline Chirurgiche Morfologiche e Metodologie Integrate, Università degli Studi di Genova.
authors.forename: Francescopaolo
authors.initials: F
authors.lastname: Mattioli
authors.forename: Maria
authors.initials: M
authors.lastname: Puglisi
authors.forename: Paola
authors.initials: P
authors.lastname: Ceppa
authors.forename: Monica
authors.initials: M
authors.lastname: Peresi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Borgonovo
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ansaldo
authors.forename: Emanuela
authors.initials: E
authors.lastname: Varaldo
authors.forename: Luca
authors.initials: L
authors.lastname: Milone
authors.forename: Michela
authors.initials: M
authors.lastname: Assalino
authors.forename: Gian Carlo
authors.initials: GC
authors.lastname: Torre
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D007082:Ileum / Q000473:pathology; D016130:Immunophenotyping; D007580:Jejunal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D007583:Jejunum / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D012007:Rectum / Q000473:pathology; D012307:Risk Factors; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery; D013997:Time Factors