Tumores del estroma gastrointestinal

espanolLos tumores del estroma gastrointestinal (GIST) son neoplasias mesenquimales originadas en el tracto gastrointestinal. Su localizacion mas frecuente es en estomago e intestino delgado. Pueden originarse a cualquier edad, pero mas del 80% de los casos son mayores de 50 anos sin predileccion de sexo, aunque puede observarse en pacientes mas jovenes asociados a sindromes que predisponen el desarrollo de estos tumores. Presentan sintomatologia inespecifica. La tomografia axial computarizada esta recomendada para realizar el estudio de extension y seguimiento de estos pacientes. Los marcadores inmunohistoquimicos mas sensibles y especificos son el KIT y DOG1. El tratamiento en caso de lesiones primarias localizadas es la reseccion quirurgica, con o sin terapia adyuvante con imatinib durante 3 anos en dependencia del riesgo de recidiva. En los casos avanzados o metastasicos se recomienda terapia neoadyuvante con imatinib por tiempo indefinido; el tratamiento en casos de progresion o intolerancia a imatinib es el sunitinib EnglishGastrointestinal stromal tumors (GIST) are mesenchymal neoplasms that arise in the gastrointestinal tract, usually in the stomach or the small intestine. GISTs can arise at any age, but more than 80% are reported in individuals older than 50 years men and women are affected at a roughly similar frequency. The few patients are who younger frequently have GIST associated with a syndrome. The clinical manifestations are non-specifics. The computer-tomography is recommended for staging and follow-up. The KIT and DOG1 are the most sensitive and specific immunohistochemistry markers. The standard treatment of localized GIST is complete surgical excision of the lesion, with or without adjuvant imatinib in dependence with the relapse risk. Neoadjuvant imatinib is the standard treatment for locally advanced and metastatic disease. In locally advanced and metastatic disease the imatinib treatment should be continued indefinitely. Following confirmed progression, or intolerance, to imatinib the standard second-line treatment is sunitinib.