Clinical Decision and Treatment for Gastrointestinal Stromal Tumor(GIST) of the Intestine Fumihito Hirai 1 , Toshiyuki Matsui 1 , Tsuneyoshi Yao 1 1Department of Gastroenterology, Fukuoka University Chikushi Hospital Keyword: gastrointestinal mesenchymal tumor(GIMT) , gastrointestinal stromal tumor(GIST) , Rosai 分類 pp.561-573
Published Date 2004/4/24
DOI https://doi.org/10.11477/mf.1403100497
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 Gastrointestinal stromal tumor(GIST)of the intestine is a rare entity and the diagnosis, clinical features and clinical treatment are not yet clear. The aim of this study is to clarify the clinical decision for patients with GIST of the intestine. Eighteen patients(4 : male,14: female)with GIST of the intestine(12: jejunum,4: ileum,2: rectum)were studied. Clinical features, findings of X-ray examination,US,CT scan and angiography and pathological characteristics(site, size, growth pattern, superficial findings, subtype of GIST)were investigated. X-ray examination,US,CT scan and angiography were able, to a great extent, to reveal the existence of GIST tumors. Especially, X-ray examination can make it possible to estimate the extraluminal pattern and superficial condition(ulcer, erosion)of the tumors. Therefore, it was possible to distinguish GIST from other tumors of the intestine by using these diagnostic images.

 Tumor size greater than5cm and nodular surface were associated with a high risk of malignancy. All cases were GIST in the wide sense by Rosai's classification. Using this classification, our cases of GIST were classified into3cases of neural(N)type,8of smooth muscle(SM)type,2of combined smooth muscle-neural(CSMN)type and5of uncommitted(U,GIST in the narrow sense)type. It was difficult to distinguish subtypes of GIST by any of the diagnostic images available to us. Neither was there any relationship between subtypes of GIST and malignant potential in this study. Until now, we have treated these tumors as conventional myogenic tumors, not as GIST subtypes, but, there was no major clinical consequence. Maybe clinical decision for subtypes of GIST should be the same as that we make for conventional myogenic tumors.

 1) Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan

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