[Gastrointestinal stromal tumors localized in small intestine and diagnosed preoperatively as gynecological neoplasms].
OBJECTIVE
The aim of the study was the analysis of women with gastrointestinal stromal tumors (GIST) of small intestine treated and followed-up in Cancer Center-Institute in Warsaw, who were primary operated in gynecological departments due to suspicion of gynecological neoplasm.


METHODS
In the database of Clinical GIST Registry from 2001 to 2004 we identified 44 women with the diagnosis of CD117(+) GIST of small intestine, what corresponds to 34% (44/130) all female GIST patients. Sixteen of them (36.4%, 16/44) were primary operated on in gynecological departments due to the tentative diagnosis of gynecological neoplasm.


RESULTS
The only indication for operation in 29 women was undiagnosed microscopically tumor of the pelvis. Sixteen of them (55.2%, 16/29) were operated on schedule in gynecological departments. The others 15 patients were operated due to: ileus and perforation of digestive tract (8), gastrointestinal bleeding (3), abdominal pain (2) and others (2). In analyzed group of patients 20 women (45.5%) after GIST excision remain without evidence of disease with median follow-up time of 9 months, and in 24 patients (54.5%) GIST recurred in median time of 18.5 months. In this latter group 23 patients were treated with imatinib due to inoperable/metastatic lesions. Estimated 2-year overall survival (calculated form the date of imatinib introduction) was 75%.


CONCLUSIONS
GISTs, especially of small intestine, may simulate in women gynecological tumor, particularly of the ovary. Radical surgery remains the most effective method of GIST treatment. In inoperable/metastatic lesion the treatment of choice is tyrosinase kinase inhibitor--imatinib.
Zbigniew
Nowecki
N
Klinika Nowotworów Tkanek Miekkich i Kości, Warszawa. nowecki@coi.waw.pl
Piotr
Rutkowski
R
Bogusław
Lindner
L
Wanda
Michej
M
Włodzimierz
Ruka
R
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001549:Benzamides; D003937:Diagnosis, Differential; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D005833:Genital Neoplasms, Female / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D000068877:Imatinib Mesylate; D007421:Intestine, Small / Q000601:surgery*; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage; D011379:Prognosis; D011743:Pyrimidines / Q000008:administration & dosage; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate