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Gastrointestinal Stromal Tumors

by Elliot M. Livstone, MD

Gastrointestinal stromal tumors are tumors of the GI tract derived from mesenchymal precursor cells in the gut wall. They result from mutations of a growth factor receptor gene, C-KIT . Some are caused by previous radiation therapy to the abdomen for other tumors.

Tumors are slow growing, and malignant potential varies from minimal to significant. Most (60 to 70%) occur in the stomach, 20 to 25% in the small bowel, and a small number in the esophagus, colon, and rectum. Average age at presentation is 50 to 60.

Symptoms vary with location but include bleeding, dyspepsia, and obstruction. Diagnosis is usually by endoscopy, with biopsy and endoscopic ultrasonography for staging. Treatment is surgical removal. The role of radiation and chemotherapy is unclear, but the tyrosine kinase inhibitor imatinib has been beneficial.

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