| Theme |
Mesenchymal neoplasms of the colon and rectum : excluding lymphoproliferative disorders |
| Title |
Diagnosis and treatment of GIST and related disease |
| Author |
Masahiro Igarashi |
Department of Endoscopy, Cancer Institute Hospital |
| Author |
Naoyuki Uragami |
Department of Gastrology, Cancer Institute Hospital |
| Author |
Teruhito Kishihara |
Department of Endoscopy, Cancer Institute Hospital |
| Author |
Akiko Chino |
Department of Gastrology, Cancer Institute Hospital |
| Author |
Daishi Ogawa |
Department of Endoscopy, Cancer Institute Hospital |
| Author |
Yoshiya Fujimoto |
Department of Surgery, Cancer Institute Hospital |
| [ Summary ] |
The diagnosis and treatment of gastrointestinal mesenchymal tumors (GIMT) are summarized. The frequency of GIMT in the lower digestive tract is very rare. GIST is the most frequent form of GIMT, occuring primarily in the rectum. If a submucosal tumor is detected in the rectum, it should be studied with image modalities such as barium enemas, EUS, CT or MRI. A very important measure was to develop histological diagnose through immunohistological examinations. Diagnosis by examination of KIT, CD-34, SMA, desmin, and S-100 proteins was particularly important. EUS-FNAB was one useful procedure for a preoperative diagnosis. When treatment options are settled on the care-givers accept the decision and an operation is planned. With GIST in particular, imatinib mesylate is indicated for nonoperable cases and incompletely resected patients. |