Introduction: Gastrointestinal stromal tumor (GIST) is a rare neoplasm exhibiting, in most cases, mutations of c-kit tyrosine kinase, it is the most common mesenchymal tumor of the gastrointestinal tract. Two thirds of all gut malignant GISTs occur in the stomach. Material and Methods: 13 patients presented with GIST tumors from the period of January 2000 to August 2010. Surgical treatment done in all patients with local Gastric wedge resection in 4 patients, subtotal gastrectomy in 3,total gastrectomy in 2, laparoscopic proximal gastrectomy in 1,distal gastrectomy in 2 patient. A very huge intraabdominal mass more than 8 kilograms was resected from intraabdominal cavity with the involved stomach. In all the patients safe margin of at least 2 cmwas ascertained and safty margin were carefully looked for with frozen section in the last 5 cases. Lymhadenectomy was not necessary. Imatinib was used post-operatively in all the patients. Results: There were 9males and 4 females, with age range from21 years to 64 years. Patients presented with upper gastrointestinal bleeding in 4 patients, abdominal mass and weight loss in 5, dysphagia in 3 patients, while one patient presented acutelywith haemoperitoneum. Preoperative diagnosis was done in 4 patients as gastric GIST, while in the remainder the diagnosis was done postoperatively. Gastric tumors located in the cardia of the stomach in 2 patients, body of the stomach in 6 patients and the antrumin 2 patients. There was no operative mortality. follow up from 6months to 6 years, there were two deaths 18months afterR1 resection in one, and 24months in the other. Other patients followed in the oncology department, with no recurrences. Conclusion: The therapy of choice of resectable GIST is complete surgical removal of the tumor. Lymphadenectomy is not necessary; GIST rarely involves the loco regional lymph nodes. The margins of resection from the tumor specimen should be carefully oriented and examined. Laparoscopic resection is feasible and was successfully applied to the management of GIST. Tumour pathological characteristics Tumor characteristics Patients Size of tumor----- 10Cm 4 Mitotic figure ----- 5/50 HPF 7 CD 117 Positive 13 Residual disease Micr 11 Positive 2
Introduction: Gastrointestinal stromal tumor (GIST) is a rare neoplasm exhibiting, in most cases, mutations of c-kit tyrosine kinase, it is the most common mesenchymal tumor of the gastrointestinal tract. Two thirds of all gut malignant GISTs occur in the stomach. Material and Methods: 13 patients presented with GIST tumors from the period of January 2000 to August 2010. Surgical treatment done in all patients with local Gastric wedge resection in 4 patients, subtotal gastrectomy in 3,total gastrectomy in 2, laparoscopic proximal gastrectomy in 1,distal gastrectomy in 2 patient. A very huge intraabdominal mass more than 8 kilograms was resected from intraabdominal cavity with the involved stomach. In all the patients safe margin of at least 2 cmwas ascertained and safty margin were carefully looked for with frozen section in the last 5 cases. Lymhadenectomy was not necessary. Imatinib was used post-operatively in all the patients. Results: There were 9males and 4 females, with age range from21 years to 64 years. Patients presented with upper gastrointestinal bleeding in 4 patients, abdominal mass and weight loss in 5, dysphagia in 3 patients, while one patient presented acutelywith haemoperitoneum. Preoperative diagnosis was done in 4 patients as gastric GIST, while in the remainder the diagnosis was done postoperatively. Gastric tumors located in the cardia of the stomach in 2 patients, body of the stomach in 6 patients and the antrumin 2 patients. There was no operative mortality. follow up from 6months to 6 years, there were two deaths 18months afterR1 resection in one, and 24months in the other. Other patients followed in the oncology department, with no recurrences. Conclusion: The therapy of choice of resectable GIST is complete surgical removal of the tumor. Lymphadenectomy is not necessary; GIST rarely involves the loco regional lymph nodes. The margins of resection from the tumor specimen should be carefully oriented and examined. Laparoscopic resection is feasible and was successfully applied to the management of GIST. Tumour pathological characteristics Tumor characteristics Patients Size of tumor----- 10Cm 4 Mitotic figure ----- 5/50 HPF 7 CD 117 Positive 13 Residual disease Micr 11 Positive 2