Gastrointestinal Stromal tumors

Question 1

GIST is previously known as?

Answer 1

Leiomyosarcoma

Question 2

Cell of origin?

Answer 2

Interstitial cells of CAJAL

Question 3

Where is it found?

Answer 3

GI tract - esophagus to rectume
most common in stomach (60%)
small bowel (30%)

Question 4

What are the symptoms?

Answer 4

GI bleed, occult GI bleed, abdominal pain

Abdominal mass, nausea, distention

Question 5

How is it diagnosed?

Answer 5

CTscan, EGD, colonoscopy

Question 6

How are distant metastasis diagnosed?

Answer 6

PET

Question 7

What is the tumor marker?

Answer 7

C-KIT (CD 117 Ag)

Question 8

What is the prognosis

Answer 8

Local spread, distal metastasis

Poor long term prognosis: >5cm, mitotic rate >5per 50 HPF

Question 9

What is the treatment?

Answer 9

Resect with negative margins with chemotherapy

Question 10

Is LN dissection needed?

Answer 10

NO

Question 11

Chemotherapy for metastatic or advanced disease?

Answer 11

Imatinib

Question 12

What is Maltoma?

Answer 12

Mucosal-associated-lymphoproliferative Tussue

Question 13

What is the most common site of MALTOMA?

Answer 13

Stomach

Question 14

What is the causative agent?

Answer 14

H. Pylori

Question 15

What is the medical treatment?

Answer 15

Non surgical: triple therapy and chemotherapy/XRT in refractory cases

Question 16

Twisting of the stomach is?

Answer 16

Gastric volvulus

Question 17

What are the Symptoms of Gastric Volvulus?

Answer 17

Borchard’s Triad:

1. Distention of epigastrium
2. Cannot pass and NGT
3. Emesis followed by inability to vomit

Question 18

What is the treatment for Gastric Volvulus?

Answer 18

Exploratory laparotomy to untwist, and gastropexy