Optimal management of GIST tumors located near the gastroesophageal junction: Case report and review of the literature

Ismael, Hishaam; Ragoza, Yury; Caccitolo, James A.; Cox, Steven

doi:10.1016/j.ijscr.2016.06.006

Cited by 15 publications

(18 citation statements)

References 26 publications

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“…Therefore total laparoscopic proximal gastrectomy has been proposed by some authors [ 4 , 5 , 7 ]. Still, this is considered too invasive for the resection of GISTs [ 8 , 9 ]. To solve this issue, Tagaya et al, in 2002 reported the technique of intragastric resection; balloon-type ports were inserted into the gastric lumen via the gastric wall to remove the tumor, yet this equipment wasn't always available and created a difficulty for the surgical team [ [10] , [11] , [12] ].…”

Section: Discussionmentioning

confidence: 99%

“A hybrid approach for GISTs near the esophagogastric junction, a case report”

Aguayo¹,

Rojas²,

Molina

et al. 2021

Annals of Medicine and Surgery

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Introduction and importance Gastrointestinal stromal tumors are the most frequent mesenchymal tumors of the gastrointestinal tract. Complete resection of GISTs is the only chance of cure for patients. When these tumors are located near the esophagogastric junction, the surgical risk can cause deformity or stenosis in the gastric inlet, leading to higher complications and diminishing their quality of life. In such cases, a more sophisticated and tailored approach should be used. Case presentation We present the case of a 42-year-old female; she presented to our office with a 3-year history of nausea, vomiting and abdominal distension. Two GISTs were located near the EGJ, and with a combined approach we achieved complete resection. On follow-ups, the patient is doing well. Clinical Discussion, Conclusion When diagnosis is confirmed, surgical resection must be the first choice for GISTs as complete surgical excision is the only permanent cure. The rise of endoscopic surgery has become a valuable tool and a critical element in surgery. Hybrid techniques that combine laparoscopic and endoscopic approaches can improve the patient's outcomes and provide better results.

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Section: Discussionmentioning

confidence: 99%

“A hybrid approach for GISTs near the esophagogastric junction, a case report”

Aguayo¹,

Rojas²,

Molina

et al. 2021

Annals of Medicine and Surgery

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“…Although there are still debates about the laparoscopic resection of large GISTs exceeding 5 cm, there are some new studies that confirm the safety and feasibility of this method [ 4 , 5 , 9 , 15 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of LR are less bleeding, less pain, faster return of bowel function, earlier initiation of oral regimen, shorter hospital stay, faster recovery, smaller incisions and better view of identifying the progression of the tumor to the liver or peritoneum [ 2 , 5 , 9 , 14 , 17 ]. In IHC CD117 (C-kit) is positive in 95–100% of GISTs, and CD34 is positive in some cases.…”

Section: Discussionmentioning

confidence: 99%

“…Today, laparoscopic resection of GISTs, especially for tumors smaller than 5 cm, in many guidelines, such as those of the National Comprehensive Cancer Network (NCCN), is recommended as standard treatment [ 9 , 12 , 14 , 15 ]. Recent studies show the safety and feasibility of laparoscopic resection in large (> 5 cm) and giant (> 10 cm) GISTs with oncologic results comparable to those of open surgery [ 4 , 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic total gastrectomy for a giant gastrointestinal stromal tumor (GIST) with acute massive gastrointestinal bleeding: a case report.

Kermansaravi

Rokhgireh

Darabi

et al. 2017

Videosurgery and Other Miniinvasive Techniques

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Gastrointestinal stromal tumors (GISTs) include 80% of gastrointestinal mesenchymal tumors that originate from interstitial Cajal cells and include 0.1–3% of GI malignancies, and the stomach is the most commonly involved organ. The only potentially curative treatment is surgical resection with clear margins. Although laparoscopic resection of small GISTs is a standard treatment, there is controversy about laparoscopic surgical resection for large and giant GISTs. A 52-year-old woman, a known case of large GIST of the stomach that was under neoadjuvant imatinib therapy, was admitted to the emergency department due to acute massive gastrointestinal bleeding (GIB). The patient underwent laparoscopic total gastrectomy and received adjuvant imatinib after surgery. Laparoscopic resection is a safe and feasible method in large and giant GISTs with oncologic and long-term outcomes comparable to open surgery, and with better short-term outcomes.

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“…If they are uniformly benign, the long-term outcome is excellent [ 29 ]. Furthermore, the standard treatment for GISTs is open or laparoscopic surgical resection with free margins [ 30 ], although recent studies demonstrated the feasibility and safety of endoscopic resection through an endoscopic submucosal dissection (ESD) technique for small tumors. GISTs have been associated with a relatively low recurrence rate during long-term follow-up despite little R 0 resection rate [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Subepithelial rectal gastrointestinal stromal tumor – the use of endoscopic ultrasound-guided fine needle aspiration to establish a definitive cytological diagnosis: a case report

et al. 2017

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BackgroundGastrointestinal stromal tumors are the most common mesenchymal neoplasms affecting the gastrointestinal tract. The stomach is the most common location to be affected, and the rectum one of the rarest, but the whole gastrointestinal tract remains susceptible. Gastrointestinal stromal tumors account for only 0.1% of rectal tumors. Currently, endoscopic ultrasound plays an essential role in the diagnostic process of gastrointestinal stromal tumors, especially when the affected sites have a worse outcome and higher morbidity rates.Case presentationWe describe the case of a 68-year-old white Japanese man with a history of long-term mild rectal pain and tenesmus. A digital rectal examination revealed a right palpable solid mass ranging from 3 to 7 cm from his anal verge. A colonoscopy was performed and showed a 5 cm elevated lesion covered by normal mucosa, located 4 cm above the pectineal line. Endoscopic ultrasound confirmed the diagnosis of a homogeneous hypoechoic mass with areas of necrosis as a rectal subepithelial lesion originating at the fourth layer (muscularis propria). He then underwent endoscopic ultrasound-guided fine needle aspiration of the lesion, followed by cytological and immunohistochemistry evaluation. The evaluation showed spindle and epithelioid cells of variable sizes, in fascicles separated by stroma, which reacted firmly and consistently to CD117/c-kit and CD34, and negative to desmin and S-100 protein. There was weak staining for nuclear Ki-67 in the tumor cells. A diagnosis of rectal gastrointestinal stromal tumor was confirmed. After a multidisciplinary meeting, an abdominoperineal resection of his rectum was performed. The pathology of the specimen confirmed the diagnosis of rectal gastrointestinal stromal tumor. He is now asymptomatic after 3 months’ follow-up and is on adjuvant therapy with a tyrosine-kinase inhibitor.ConclusionsGastrointestinal stromal tumors are rare tumors, and among the variety of primary location sites, the rectum is one of the rarest. The localization of this type of tumor has worse outcomes and higher morbidity rates. We report this rare case to emphasize the need for precise diagnosis and the important role of endoscopic ultrasound-guided fine needle aspiration in such situations.

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Optimal management of GIST tumors located near the gastroesophageal junction: Case report and review of the literature

Cited by 15 publications

References 26 publications

“A hybrid approach for GISTs near the esophagogastric junction, a case report”

“A hybrid approach for GISTs near the esophagogastric junction, a case report”

Laparoscopic total gastrectomy for a giant gastrointestinal stromal tumor (GIST) with acute massive gastrointestinal bleeding: a case report.

Subepithelial rectal gastrointestinal stromal tumor – the use of endoscopic ultrasound-guided fine needle aspiration to establish a definitive cytological diagnosis: a case report

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