Journal of Cancer Research and Treatment, 2017, Vol. 5, No. 2, 68-72
Available online at http://pubs.sciepub.com/jcrt/5/2/5
©Science and Education Publishing
DOI:10.12691/jcrt-5-2-5
Gastrointestinal Stromal Tumors: A Focus
on Diagnosis and Management
Ahmed M. Kabel
1,2,*
, Ahad D. Alofi
3
, Aisha H. Almalki
3
, Asrar A. Al Qurashi
3
, Maha S. Al Ghamdi
3
1
Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, KSA
2
Department of Pharmacology, Faculty of Medicine, Tanta University, Tanta, Egypt
3
Final year student, College of Pharmacy, Taif University, Taif, KSA
*Corresponding author: drakabel@gmail.com
Abstract Gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal (GI) tract that usually
start in very early forms of special cells found in the wall of the GI tract, called the interstitial cells of Cajal (ICCs).
Symptoms are usually variable, depending on tumor size and location, but many patients are asymptomatic. Most
gastrointestinal stromal tumors (GISTs) occur in the stomach or small intestine. These tumors might not cause any
symptoms unless they are in a certain location or grow to a certain size. Small tumors might not cause any symptoms
and may be found accidentally when the physician is looking for another problem. These tumors are often benign.
The main treatment for GIST that hasn’t spread is usually surgery to remove all of the tumors. The above mentioned
topics, as well as classification, causes, clinical presentation, diagnosis and prognosis of GISTs were discussed in
this review.
Keywords: gastrointestinal, stroma, tumor, diagnosis, management
Cite This Article: Ahmed M. Kabel, Ahad D. Alofi, Aisha H. Almalki, Asrar A. Al Qurashi, and Maha S. Al
Ghamdi, “Gastrointestinal Stromal Tumors: A Focus on Diagnosis and Management.” Journal of Cancer
Research and Treatment, vol. 5, no. 2 (2017): 68-72. doi: 10.12691/jcrt-5-2-5.
1. Introduction
Gastrointestinal stromal tumors (GISTs) are not
common disease, and the exact number of people
diagnosed with these tumors each year is not known. Until
the late 1990s, not much was known about these tumors,
so many of them ended up being classified as other kinds
of GI cancers [1]. Current estimates for the total number
of GIST cases each year in the United States range from
about 4,000 to about 5,000. These tumors can start
anywhere in the GI tract, but they occur most often in the
stomach (about 60%) or the small intestine (about 30%).
Most of the rest are found in the esophagus, colon, and
rectum. A small number develop in the abdomen outside
the GI tract. Most people diagnosed with GIST are older
than 50, but these tumors can occur in people at any age.
They are slightly more common in men [2].
Cancer starts when cells in the body begin to grow out
of control. Cells in nearly any part of the body can become
cancer, and can spread to other areas of the body [3].
Gastrointestinal stromal tumors start in the digestive
system. Gastrointestinal stromal tumors (GISTs) are
uncommon tumors of the GI tract. These tumors start in
very early forms of special cells found in the wall of the
GI tract, called the interstitial cells of Cajal (ICCs). ICCs
are cells of the autonomic nervous system, the part of the
nervous system that regulates body processes such as
digesting food. ICCs are sometimes called the
“pacemakers” of the GI tract because they signal the
muscles in the digestive system to contract to move food
and liquid through the GI tract [4]. More than half of
GISTs start in the stomach. Most of the others start in the
small intestine, but GISTs can start anywhere along the GI
tract. A small number of GISTs start outside the GI tract
in nearby areas such as the omentum (an apron-like layer
of fatty tissue that hangs over the organs in the abdomen)
or the peritoneum (the layer of tissue that lines the organs
and walls of the abdomen). Not all GISTs are cancerous.
Some are benign (not cancerous) and don’t grow into
other areas or spread to other parts of the body. Doctors
have ways to find out whether a GIST is benign or
cancerous [5].
2. Classification of GISTs
GISTs are usually classified according to the site of
origin of the primary tumor [6]. GISTs that start in the
stomach or the omentum are classified into four main
stages under which there are subdivisions. In stage IA, the
tumor is not larger than 5 cm in diameter (T1 or T2), not
spread to the nearby lymph nodes (N0) or distant sites
(M0) with low mitotic rate. In stage IB, the tumor is larger
than 5 cm but not larger than 10 cm in diameter (T3), not
spread to nearby lymph nodes (N0) or distant sites (M0)
with low mitotic rate. In stage IIA, the tumor is no larger
than 5 cm in diameter (T1 or T2). The tumor has not
spread to nearby lymph nodes (N0) or distant sites (M0)
with high mitotic rate. In stage IIB, the tumor is larger
than 10 cm in diameter (T4), not spread to the nearby