title: Giant gastrointestinal stromal tumor of the stomach.
abstract: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal malignancies of the digestive tract. Gastric localization is the most frequent. The aim of this study is to evaluate the importance of immunohistochemical factors (CD117, CD34, α-SMA, vimentin, p53, Ki67) in diagnostic and size tumor and mitotic activity as prognostic factors for these tumors. We present the case of a 66-year-old male patient with a giant gastric GIST. Like in the vast majority, the symptomatology in this patient has long been faint, despite the large tumor size, and when it became manifest, it was nonspecific. Imagery wise, the computer tomography (CT) scan was the most efficient, showing the origin of the tumor from the greater curvature of the stomach, its dimensions, as well as the relations with the other abdominal viscera. Surgery in this patient was en-bloc, according to the principles of GIST. The histological aspect is characterized by a proliferation of spindle cells positive for CD117 and CD34. Despite complete microscopic resection, the size of the tumor (25×20×27 cm) and the mitotic activity (21÷5 mm2) remains important relapse factor.
authors.affiliation: Department of Surgery, "Iuliu Hatieganu" University of Medicine and Pharmacy; Surgery Clinic I, County Hospital, Cluj-Napoca, Romania; ionescu_calincj2002@yahoo.com.
authors.forename: Sever
authors.initials: S
authors.lastname: Ionescu
authors.forename: Emil
authors.initials: E
authors.lastname: Barbu
authors.forename: Călin
authors.initials: C
authors.lastname: Ionescu
authors.forename: Adrian
authors.initials: A
authors.lastname: Costache
authors.forename: Maria
authors.initials: M
authors.lastname: Bălăşoiu
mesh_terms: D000199:Actins / Q000378:metabolism; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D018450:Disease Progression; D005753:Gastric Mucosa / Q000378:metabolism*; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D009364:Neoplasm Recurrence, Local; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism*; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: C541116:ACTA2 protein, human; D000199:Actins; D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D019009:Proto-Oncogene Proteins c-kit