Gastrointestinal stromal tumor: Evaluation of 5 cases

Abstract

Purpose: The aim of this study was to analyze and discuss the clinical findings and the treatment in five patients with GIST in view of current literature.

Patients and Methods: We retrospectively analyzed five patients with GIST who were followed and treated between 2008-2009 in our clinic.

Results: We herein report five patients (4 males and 1 female) with a median age of 66.2 years (range, 58-73 years); 4 with tumors located in stomach and 1 in small intestine. Symptoms were not typical and depended on the localization and size of the tumor. Tumor sizes ranged between 3 and 10 cm (average 5.6 cm). Positivity rates for CD117 and CD34 expression determined by immunohistochemical methods were 80%. CD117 and CD34 expression was negative in one patient (%20). Five cases underwent complete tumor resection. In one case, where histopathological results showed low risk, the tumor was resected laparoscopically. The other patients were treated by open surgery. In one case a small intestinal stromal tumor was localised in the ileum. Segmental resection of the involved portions of the intestine was performed. In one patient, enlarged perigastric LNs were detected during laparotomy and the patient underwent total gastrectomy with en bloc perigastric LN dissection. Lymph node metastasis was observed in 5 of 12 resected perigastric nodes. No recurrence or metastasis has been detected during 6 months postoperative follow-up. No lymph node metastases were observed in the other patients.

Conclusion: The prognosis of GIST depends on its size and mitotic activity. Surgical resection along with imatinib mesylate therapy is the best treatment for GIST. Complete surgical resection with negative tumor margins is the principal curative procedure for primary and non-metastatic tumors.