A clinical study on presentation, age distribution, various diagnostic methods adopted, treatment modalities being used and outcome of gastrointestinal stromal tumors


  • Chinthakindhi Madhusudhan Department of Surgery Gastroenterology, Osmania General Hospital, Afzulgunj, Hyderabad, Telangana, India
  • Vinod Kumar Jyothiprakasan Department of General Surgery, Malla Reddy Medical College for Women, Jeedimetla, Medchal, Telangana, India
  • Veeresh Sriram Department of Surgery Gastroenterology, Osmania General Hospital, Afzulgunj, Hyderabad, Telangana, India




Age distribution, Diagnostic methods, Outcome, Presentation


Background: Gastro intestinal stromal tumors (GIST) are primary distinctive mesenchymal tumors of the gastro intestinal tract. Early diagnosis is important for better clinical outcome. The objective was to study presentation, age distribution, various diagnostic methods adopted, treatment modalities being used and outcome of gastrointestinal stromal tumors.

Methods: Prospective and retrospective, descriptive study was carried out. After admission of the patient, a detailed clinical history was taken. Physical examination was carried out in detail as per the study proforma and findings were noted. All cases provisionally diagnosed as GISTS were further investigated.

Results: Males and females were equally present i.e. 50% each. Pain in the abdomen was the most common clinical presentation in 66.7% of the cases. 12 cases (66.7%) of GISTs present in the stomach and 6 cases (33.3%) of GISTs present in the duodenum in various locations. Diagnostic confirmation was done for all the 18 cases by histopathology. Out of these 18 cases, 10 cases are benign GISTS (55.6%), whereas 8 cases were of malignant GISTS (44.4%). In total, among all the cases, 10 cases are spindle cell type (55.6%), 6 cases of epithelioid type (33.3%) and 2 cases of mixed cell type tumors (11.1%) are seen.

Conclusions: GIST is more a disease of elder age group. CECT abdomen is a good diagnostic modality in detection of GIST. Wide excision with negative margins (2cm from tumor margin) is adequate and treatment of choice for benign tumors.



World Health Organization Classification of Tumours. Pathology and genetics of tumours of the digestive system by Hamilton SR, Aaltonen LA. IARC: Lyon, 2000. Available at: https://www.iarc.fr/wp-content/uploads/2018/07/BB2.pdf. Accessed 12 May 2013.

DeMatteo RP. The GIST of targeted cancer therapy: a tumor (gastrointestinal stromal tumor), a mutated gene (c-kit), and a molecular inhibitor (STI571). Ann Surg Oncol. 2002;9(9):831-9.

Joensuu H, Fletcher C, Dimitrijevic S, Silberman S, Roberts P, Demetri G. Management of malignant gastrointestinal stromal tumours. Lancet Oncol. 2002;3(11):655-64.

O'Leary T, Berman JJ. Gastrointestinal stromal tumors: answers and questions. Human Pathol. 2002;33(5):456-8.

Oosterom AT, Judson I, Verweij J, Stroobants S, Di Paola ED, Dimitrijevic S, et al. Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study. Lancet. 2001;358(9291):1421-3.

Lv M, Wu C, Zheng Y, Zhao N. Incidence and survival analysis of gastrointestinal stromal tumors in shanghai: a population-based study from 2001 to 2010. Gastroenterol Res Prac. 2014.

Poškus E, Petrik P, Petrik E, Lipnickas V, Stanaitis J, Strupas K. Surgical management of gastrointestinal stromal tumors: a single center experience. Videosurg Other Miniinvasive Tech. 2014;9(1):71.

Roggin KK, Posner MC. Modern treatment of gastric gastrointestinal stromal tumors. World J Gastroenterol: WJG. 2012;18(46):6720.

Qi Y, Zhao W, Wang Z, Li T, Meng X. Tumor sites and microscopic indicators are independent prognosis predictors of gastrointestinal stromal tumors. Tohoku J Exp Med. 2014;233(1):65-72.

Suster S. Gastrointestinal stromal tumors. Sem Diagn Pathol. 1996;13(4):297-313.

Agaimy A, Terracciano LM, Dirnhofer S, Tornillo L, Foerster A, Hartmann A, et al. V600E BRAF mutations are alternative early molecular events in a subset of KIT/PDGFRA wild-type gastrointestinal stromal tumours. J Clin Pathol. 2009;62(7):613-6.

Gong J, Kang W, Zhu J, Xu J. CT and MR imaging of gastrointestinal stromal tumor of stomach: a pictorial review. Quantitative Imaging Med Surg. 2012;2(4):274.

Antonopoulos P, Leonardou P, Barbagiannis N, Alexiou K, Demonakou M, Economou N. Gastrointestinal and extragastrointestinal stromal tumors: report of two cases and review of the literature. Case Rep Gastroenterol. 2014;8(1):61-6.

Sokolich J, Galanopoulos C, Dunn E, Linder JD, Jeyarajah DR. Expanding the indications for laparoscopic gastric resection for gastrointestinal stromal tumors. JSLS: J Soc Laparo-endoscopic Surg. 2009;13(2):165.

Everett M, Gutman H. Surgical management of gastrointestinal stromal tumors: analysis of outcome with respect to surgical margins and technique. J Surg Oncol. 2008;98(8):588-93.

Miettinen M, Wang ZF, Lasota J. DOG1 antibody in the differential diagnosis of gastrointestinal stromal tumors: a study of 1840 cases. Am J Surg Pathol. 2009;33(9):1401-8.

Agaimy A. Gastrointestinal stromal tumors (GIST) from risk stratification systems to the new TNM proposal: more questions than answers? a review emphasizing the need for a standardized GIST reporting. Inter J Clin Exp Pathol. 2010;3(5):461.






Original Research Articles