A Gastrointestinal Stromal Tumour (GIST) - a Case Report

Introduction: Gastrointestinal stromal tumours are the most common mesenchymal neoplasms of the GI tract with the following abdominal distribution: stomach - 40-60%, small intestine - 30%, extraintestinal localisation - below 9%. The usual symptoms are: GI bleeding, fever, night sweats, weight loss, palpable mass, symptoms of compression. Materials and Methods: The case refers to a 34-year-old male patient (2013). Results and Discussion: Radical tumour resection along with small intestine resection was performed. One year later multiple resections of recurrent pelvic, mesocolic, omental and peritoneal tumours were performed. After immunohistochemical re-examination, the primary diagnosis - leiomyosarcoma, was replaced by a poorly differentiated GIST. Imatinib treatment course was conducted. Due to a second recurrence, en bloc resection of a large pelvic mass infiltrating the urinary bladder and the rectum was performed. Macroscopically clear resection lines were achieved. Conclusions: Surgery is the only curative treatment of GIST. If R0 resection lines are impossible to achieve and highly aggressive malignancies are present, adjuvant tyrosine-kinase inhibitors therapy is recommended. The 5-year survival rate after radical surgery is 48 to 64%. The recurrence risk is increased by: large tumour mass, high mitotic index, extraintestinal localisation.