title: Giant gastrointestinal stromal tumor presenting as a palpable abdominal mass: an unusual presentation.
abstract: Gastrointestinal stromal tumors (GIST-) account for the majority of mesenchymal tumors arising within the gastrointestinal tract. GIST presenting as a palpable abdominal mass is extremely rare. We report four additional cases of a GIST presenting as an abdominal mass along with a pertinent review of the literature. Twenty five cases of GISTs presenting with an abdominal mass, including 4 cases discussed here, have been reported in the world literature since 2001. The mean duration of symptoms was 152.7 days. Twenty one of 25 (84%) patients received surgical resection. The mean tumor size was 17.2 cm, with an average mitotic index of 7.6 per 50 high power fields. Thirteen of 14 (92.9%) patients had a high-risk tumor. Five patients were disease-free at a mean followup of 11 months, 2 patients had stable disease and 2 patients had progressive disease, and one patient had a partial response. In conclusion, symptomatic patents have an increased incidence of high-risk tumors and metastases at presentation. Adjuvant therapy with imatinib improves disease-free survival in patients with large abdominal GIST tumors, but no change in overall survival was noted. Finally, GISTs should be considered in the differential diagnosis of an abdominal mass in an elderly patient.
authors.affiliation: Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ 07039, USA.
authors.forename: Sachin
authors.initials: S
authors.lastname: Patil
authors.forename: Sudhir
authors.initials: S
authors.lastname: Jain
authors.forename: R C M
authors.initials: RC
authors.lastname: Kaza
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Chamberlain
references.citation: Radiol Med. 2006 Aug;111(5):661-73
references.pmid: 16791465
references.citation: World J Surg Oncol. 2007 Nov 29;5:137
references.pmid: 18045506
references.citation: Am J Surg Pathol. 2009 Sep;33(9):1267-75
references.pmid: 19440146
references.citation: Semin Diagn Pathol. 2006 May;23(2):70-83
references.pmid: 17193820
references.citation: J Clin Oncol. 2007 May 1;25(13):1753-9
references.pmid: 17470865
references.citation: Blood. 2001 Sep 1;98(5):1365-73
references.pmid: 11520784
references.citation: Eur Radiol. 2006 Feb;16(2):422-7
references.pmid: 15726376
references.citation: J Natl Compr Canc Netw. 2010 Apr;8 Suppl 2:S1-41; quiz S42-4
references.pmid: 20457867
references.citation: Cancer. 2001 Aug 25;93(4):269-75
references.pmid: 11507701
references.citation: Oncol Rep. 2009 Apr;21(4):899-902
references.pmid: 19287986
references.citation: AJR Am J Roentgenol. 2004 Dec;183(6):1844-6
references.pmid: 15547245
references.citation: J Emerg Trauma Shock. 2009 Sep;2(3):199-202
references.pmid: 20009312
references.citation: Indian J Cancer. 2004 Oct-Dec;41(4):175-7
references.pmid: 15659872
references.citation: Clin Cancer Res. 2008 Jul 15;14(14):4550-5
references.pmid: 18628470
references.citation: Hum Pathol. 2002 May;33(5):459-65
references.pmid: 12094370
references.citation: J Korean Med Sci. 2003 Oct;18(5):751-5
references.pmid: 14555833
references.citation: Gastroenterol Hepatol (N Y). 2008 Sep;4(9):650-7
references.pmid: 22798750
references.citation: Eur J Cancer. 2002 Sep;38 Suppl 5:S37-8
references.pmid: 12528771
references.citation: J Pediatr Hematol Oncol. 2001 May;23(4):255-6
references.pmid: 11846308
references.citation: Gastroenterology Res. 2009 Dec;2(6):361-363
references.pmid: 27990209
references.citation: Eur J Surg Oncol. 2007 Oct;33(8):942-50
references.pmid: 17196360
references.citation: Am J Pathol. 2002 May;160(5):1567-72
references.pmid: 12000708
references.citation: Int J Urol. 2004 Jun;11(6):445-7
references.pmid: 15157221
references.citation: Gastric Cancer. 2003;6(1):39-48
references.pmid: 12673425
references.citation: Korean J Intern Med. 2007 Mar;22(1):21-3
references.pmid: 17427641
references.citation: JOP. 2009 Mar 09;10(2):189-91
references.pmid: 19287116