Gastrointestinal stromal tumors

Darnell, Anna; Dalmau, E.; Pericay, Carles; Musulén, Eva; Martín, Julio; Puig, Jordi; Malet, Antoni; Saigí, Eugeni; Rey, M.

doi:10.1007/s00261-004-0092-8

Cited by 43 publications

(57 citation statements)

References 25 publications

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“…Therefore, when conventional endoscopic and imaging examination fails to locate the lesions in patients with bleeding in a timely manner, emergency DSA may be a useful option. Other characteristics of the patients with small bowel GISTs, such as age, sex and abdominal pain, were similar to previous reports in the literature [2,5,6,13,16] . This study showed that there were some common DSA characteristics in small bowel GISTs.…”

Section: Discussionsupporting

confidence: 87%

“…Compared with the findings of Fang et al [17] , which showed that draining veins were found only in 27.2% (3/11) of these tumors, we think that the different appearances of the draining veins are mainly based on tumor location, size, and classification. Although CT scans [2,[9][10][11]13,17] also focus on the detection of feeding arteries and tumor blood supply, little attention has been paid to the draining veins of GISTs. In this study, in addition to the clear depiction of feeding arteries, numerous draining veins on tumors also appeared clearly in the early phase of the DSA procedures.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, two reasons that the small bowel GISTs were relatively smaller compared with previous reports [1,10,11,14] include tumor bleeding and the timely use of the DSA procedure. Furthermore, to our knowledge, this article presents the largest DSA series of small bowel GISTs to date [13,[17][18][19][20] . Based on our DSA findings, it is not difficult to detect and make a preoperative diagnosis and to locate small bowel GISTs.…”

Section: Discussionmentioning

confidence: 99%

“…Routine diagnostic imaging modalities mainly consist of endoscopic examination, computed tomography (CT) scanning, and magnetic resonance imaging (MRI) [7][8][9][10][11][12] . However, doctors who admit patients with acute or subacute obscure gastrointestinal bleeding (OGIB) prefer to conduct emergency interventional digital subtraction angiography (DSA), whereas some routine exams are not able to identify the bleeding [13][14][15] . To our knowledge, few detailed reports on the use of interventional DSA for small bowel GISTs have been published to date.…”

Section: Introductionmentioning

confidence: 99%

“…December 21, 2014|Volume 20|Issue 47| WJG|www.wjgnet.com nal metastasis [4,6,[9][10][11][12][13]21] . Therefore, CT is often the initial imaging modality used to evaluate patients who present with non-specific abdominal symptoms or a palpable abdominal mass.…”

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confidence: 99%

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Interventional digital subtraction angiography for small bowel gastrointestinal stromal tumors with bleeding

Chen¹,

Sun²,

Luo³

et al. 2014

WJG

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AIM:To retrospectively evaluate the diagnostic efficacy of interventional digital subtraction angiography (DSA) for bleeding small bowel gastrointestinal stromal tumors (GISTs). METHODS:Between January 2006 and December 2013, small bowel tumors in 25 consecutive patients undergoing emergency interventional DSA were histopathologically confirmed as GIST after surgical resection. The medical records of these patients and the effects of interventional DSA and the presentation and management of the condition were retrospectively reviewed. RESULTS:Of the 25 patients with an age range from 34-to 70-year-old (mean: 54 ± 12 years), 8 were male and 17 were female. Obscure gastrointestinal bleeding, including tarry or bloody stool and intermittent melena, was observed in all cases, and one case also involved hematemesis. Nineteen patients required acute blood transfusion. There were a total of 28 small bowel tumors detected by DSA. Among these, 20 were located in the jejunum and 8 were located in the ileum. The DSA characteristics of the GISTs included a hypervascular mass of well-defined, homogeneous enhancement and early developed draining veins. One case involved a complication of intussusception of the small intestine that was discovered during surgery. No pseudoaneurysms, arteriovenous malformations or fistulae, or arterial rupture were observed. The completely excised size was approximately 1.20 to 5.50 cm (mean: 3.05 ± 1.25 cm) in maximum diameter based on measurements after the resection. There were ulcerations (n = 8), erosions (n = 10), hyperemia and edema (n = 10) on the intra-luminal side of the tumors. Eight tumors in patients with a large amount of blood loss were treated with transcatheter arterial embolization with gelfoam particles during interventional DSA. CONCLUSION:Emergency interventional DSA is a useful imaging option for locating and diagnosing small bowel GISTs in patients with bleeding, and is an effective treatment modality.© 2014 Baishideng Publishing Group Inc. All rights reserved. Key words:Gastrointestinal stromal tumors; Small bowel; Digital subtraction angiography; Interventional; Embolization; Bleeding Core tip: This study sample is the largest of its kind, and this article includes a detailed report on the patients with small bowel gastrointestinal stromal tumors (GISTs) based on digital subtraction angiography (DSA) visualization. The data indicate that an exact location can be determined and a diagnosis of the small bowel GISTs can be made even in patients undergoing emergency interventional DSA for obscure gastrointestinal bleeding. For cases of severe anemia, these patients can also tolerate interventional DSA and management. Therefore, interventional DSA is an alternative effective imaging modality for locating and diagnosing small bowel GISTs, even in patients with bleeding.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Interventional digital subtraction angiography for small bowel gastrointestinal stromal tumors with bleeding

Chen¹,

Sun²,

Luo³

et al. 2014

WJG

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Image of the Month—Diagnosis

2009

Arch Surg

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Rupture of gastrointestinal stromal tumor presenting with sudden onset chest and back pain and accompanied by gastric dilatation

Nitta

Imamura

Yashio

et al. 2016

Acute Medicine & Surgery

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Case: A 72-year-old man with hypertension was admitted with acute-onset chest and back pain followed by epigastralgia. He was transported by helicopter due to suspected acute aortic dissection. Systolic blood pressures were equal in both arms. Physical examination showed epigastric tenderness without rebound. Blood tests showed leukocytosis. Electrocardiogram and echocardiogram were normal. Abdominal radiography showed acute gastric dilatation with an air-outlined large mass-like shadow. Abdominal computed tomography revealed a 6-cm exophytic mass and large intramural hematoma in the lesser curvature of the gastric body.Outcome: The patient underwent urgent laparotomy with total gastrectomy. The resected tumor showed positivity for CD117 and CD34 but negativity for S100, indicating a gastrointestinal stromal tumor. Fourteen days after the surgery, the patient was uneventfully discharged.Conclusion: Intramural bleeding of submucosal tumors including gastrointestinal stromal tumor should be considered in cases of acute gastric dilatation. Abdominal radiography may be a clue regarding the presence of this condition.

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Gastrointestinal stromal tumors

Abstract: GISTs can arise anywhere in the gastrointestinal tract and present a great variety of clinical and radiologic features, depending mostly on size and location.

Cited by 43 publications

References 25 publications

Interventional digital subtraction angiography for small bowel gastrointestinal stromal tumors with bleeding

Interventional digital subtraction angiography for small bowel gastrointestinal stromal tumors with bleeding

Image of the Month—Diagnosis

Rupture of gastrointestinal stromal tumor presenting with sudden onset chest and back pain and accompanied by gastric dilatation

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