What is a Gastrointestinal Stromal Tumor?A gastrointestinal stromal tumor is a tumor that originates from the cells which are present in the wall of the gastrointestinal tract called interstitial cells of Cajal(ICCs). These cells are also named as the pacemakers of the gastrointestinal tract because they convey signals to the muscles of the gastrointestinal tract which helps the GIT in the mobility of the food through contraction and relaxation of GIT musculature. Gastrointestinal tumors can arise from any part of the GIT (gastrointestinal tract) but most commonly they arise from the stomach and small intestine.
Disease Etiology (Causes)They may develop due to mutations in a certain gene name c-kit proto-oncogene. It is also associated with some hereditary syndromes (a combination of diseases) like irritable bowel syndrome, cutaneous hyperpigmentation, dysphagia, Carney triad, neurofibromatosis type 1 and diverticular disease.
Disease EpidemiologyAmong all types of gastrointestinal tumors, gastrointestinal stromal tumors are 1-3%. The overall 5-year survival rate for patients with GISTs is 77% among those diagnosed with localized diseases, 64% among those with regional diseases, and 41% with metastatic diseases according to disease surveillance epidemiology result of 2001-2011. It is more common in males as compared to females. The risk of development of the tumor increase with age reaches a maximum after the 7th decade of life. Small size gastric gastrointestinal stromal tumors (GISTs) have a better prognosis (the likely course of the disease) as compared to small size intestinal GITs.
Signs and Symptoms
- Hematemesis ( blood with vomiting)
- Melena ( black color stool due to bleeding from the upper gastrointestinal tract)
- Malaise, fatigue, and difficulty in breathing while walking or doing any physical activity due to loss of blood from the ulcerated site of the tumor.
- Abdominal pain
- Loss of appetite
- Loss of body weight
- Feeling of fullness even after a few mouthfuls
DiagnosisA diagnosis can be made through by
- Complete blood count (CBC)
- Blood coagulation profile
- BUN ( blood urea and nitrogen)
- Serum creatinine
- Liver function tests LFT’s
- Amylase and lipase values
- Imaging techniques like CT-scan, MRI, PET-scan, X-Ray, and USG to detect the site and size of the tumor.
- Preoperative biopsy