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home - Small Bowel - Small Bowel Masses - Small bowel GIST Written by Dr Sebastian Zeki

Small bowel GIST

GIST (gastrointestinal stromal tumour-most common cause of thickened folds) Clinical Pres: Overt GI bleeding — 40 percent Abdominal mass — 40 percent Abdominal pain — 20 percent Sites:Stomach (50 percent) Small bowel (25 percent) Colon (10 percent),Omentum/mesentery (7 percent),Oesophagus (5 percent) Pathogenesis:: Interstitial cells of Cajal80% have ckit mutations, some of rest have PDGFRA mutations Work up: CT EUS and biopsy- C-kit stain on biopsy specimen PET- only for definitively unresectable or metastatic GISTs Endoscopy: broad base polyp with central ulceration 50% have intragastric component Malignant potential: size/mitotic count/miss sense mutation in C-kit gene Treatment: surgery with adjuvant treatment (high recurrence rate). Glivec if advanced If more than 2cm for resection

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