Back to Program | 2010 Program and Abstracts Overview | 2010 Posters

Abstract Gastrointestinal stromal tumor (GIST) are rare malignancies that originate from the cells of Cajal, the pace maker cells of the intestine . GISTs represent 0.2% of all gastrointestinal tumors with an annual incidence of 14.5 per million persons in the US . GIST arise from the stomach 51% of the time, followed by the small intestine in 36% of cases, 12% from the colon and rectum, and 1% from the esophagus. After a thorough literature review using the search terms ‘GIST case reports ‘ and ‘GIST presentation‘ in PubMed, we found that the majority of published case reports presented with gastrointestinal hemorrhage. Upper GI bleeds are more frequent given the predominance of tumors originating from the stomach. Hemoperitoneum is also reported as an initial presentation of GIST, especially in larger tumors . A rarely reported occurrence is intratumoral hemorrhage.Furthermore, published case reports have described GIST misdiagnosed as another disease process. GISTs have masqueraded as gastric carcinoma or adenocarcinoma, squamous cell carcinoma, lung cancer, pancreatic cancer, hepatoblastoma, ovarian, uterine or vaginal tumors, testicular masses and prostate cancer . We report one case of a GIST masquerading as appendicitis; only one other such case was found in the literature. Nevertheless, these tumors also can present synchronously with other malignancies.Since a nonspecific clinical presentation and rare overall prevalence make diagnosing GIST difficult, a higher clinical suspicion should be utilized for earlier diagnosis. Imaging aids in diagnosis, gauging respectability, and surgical planning. Given that most GISTs are vascular tumors, prior endovascular embolization can also facilitate resection by controlling hemorrhage during resection. A diagnosis and treatment algorithm of GIST is presented based on our institution’s experiences and on the National Comprehensive Cancer Network (NCCN) recommendations.