Abdominal Imaging

, Volume 31, Issue 4, pp 387–399 | Cite as

Gastrointestinal stromal tumors

  • A. DarnellEmail author
  • E. Dalmau
  • C. Pericay
  • E. Musulén
  • J. Martín
  • J. Puig
  • A. Malet
  • E. Saigí
  • M. Rey



We reviewed radiologic features of gastrointestinal stromal tumors (GISTs) and correlated them with clinical and pathologic findings.


We investigated a series of 39 c-Kit–positive GISTs. Clinical and radiologic findings and management of these patients were recorded.


Twenty women and 19 men (mean age 64 years) had histologically proved GIST. Tumor locations were the small bowel (n = 20), stomach (n = 14), rectum (n = 4), and omentum (n = l). Symptoms at presentation were most frequently gastrointestinal bleeding (n = 14) and abdominal pain (n = l1). Tumors were classified as very low risk (n = 2), low risk (n = 10), intermediate risk (n = 12), and high risk (n = 11). Ultrasonography, computed tomography, magnetic resonance, digital subtraction angiography, and barium series were used in the evaluation of these tumors. Most tumors were seen as well-delineated soft tissue masses with heterogeneous contrast enhancement. Necrosis, calcification, and ulceration were most commonly seen in large tumors that presented a more aggressive behavior.


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


Gastrointestinal stromal tumor Gastrointestinal tract, neoplasm Gastrointestinal tract, magnetic resonance 



We thank John Giba for linguistic support in the preparation of this report.


  1. 1.
    Miettinen M, Lasota J (2001) Gastrointestinal stromal tumours—definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch 438:1–12PubMedCrossRefGoogle Scholar
  2. 2.
    Sarlomo-Rikala M, Kovatich AJ, Barusevicius A, Miettinen M (1998) CD117: a sensitive marker for gastrointestinal stromal tumors that is more specific than CD34. Mod Pathol 11:728–734PubMedGoogle Scholar
  3. 3.
    de Saint Aubain Somerhausen N, Fletcher CDM (1998) Gastrointestinal stromal tumors: an update. Sarcoma 2:133–141CrossRefGoogle Scholar
  4. 4.
    Franquemont DW (1995) Differentiation and risk assessment of gastrointestinal stromal tumors. Am J Clin Pathol 103:41–47PubMedGoogle Scholar
  5. 5.
    Hirota S, Isozaki K, Moriyama Y, et al. (1998) Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 279:577–580PubMedCrossRefGoogle Scholar
  6. 6.
    Kitabayashi K, Seki T, Kishimoto K, et al. (2001) A spontaneously ruptured gastric stromal tumor presenting as generalized peritonitis: report of a case. Surg Today 31:350–354PubMedCrossRefGoogle Scholar
  7. 7.
    Takahashi Y, Noguchi T, Takeno S, et al. (2001) Gastrointestinal stromal tumor of the duodenal ampulla: report of a case. Surg Today 31:722–726PubMedCrossRefGoogle Scholar
  8. 8.
    Fukuda H, Suwa T, Kimura F, et al. (2001) Gastrointestinal stromal tumor of the lesser omentum: report of a case. Surg Today 31:715–718PubMedCrossRefGoogle Scholar
  9. 9.
    Gorospe L, Simón MJ, Lima F, et al. (2002) Primary mesenteric tumor with phenotypical features of gastrointestinal stromal tumors. Eur Radiol 12:S82–S85PubMedCrossRefGoogle Scholar
  10. 10.
    Hama Y, Okizuka H, Odajima K, et al. (2002) Gastrointestinal stromal tumor of the rectum. Eur Radiol 11:216–219CrossRefGoogle Scholar
  11. 11.
    Johnston A, Khan A, Bleakney R, Keenan R (2001) Stromal tumour within a Meckel’s diverticulum: CT and ultrasound findings. Br J Radiol 74:1142–1144PubMedGoogle Scholar
  12. 12.
    van den Berg JC, van Heesewijk JPM, van Es HW (2000) Malignant stromal tumour of the rectum: findings at endorectal ultrasound and MRI. Br J Radiol 73:1010–1012PubMedGoogle Scholar
  13. 13.
    Lau S, Lui CY, Yeung YP, et al. (2003) Gastrointestinal stromal tumor of rectum: a report of 2 cases. J Comput Assist Tomogr 27:609–615PubMedCrossRefGoogle Scholar
  14. 14.
    Burkill GJ, Badran M, Al-Muderis O, et al. (2003) Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. Radiology 226:527–532PubMedGoogle Scholar
  15. 15.
    Levy AD, Remotti HE, Thompson WM, et al. (2003) Gastrointestinal stromal tumors: radiologic features with pathologic correlation. Radiographics 23:283–304PubMedGoogle Scholar
  16. 16.
    Hasegawa S, Semelka RC, Noone TC, et al. (1998) Gastric stromal sarcomas: correlation of MR imaging and histopathologic findings in nine patients. Radiology 208:591–595PubMedGoogle Scholar
  17. 17.
    Levy AD, Remotti HE, Thompson WM, et al. (2003) Anorectal gastrointestinal stromal tumours: CT and MR imagines features with clinical and pathologic correlation. AJR 180:1607–1612PubMedGoogle Scholar
  18. 18.
    Ghanem N, Altehoefer C, Furtwangler A, et al. (2003) Computed tomography in gastrointestinal stromal tumors. Eur Radiol 13:1669–1678PubMedCrossRefGoogle Scholar
  19. 19.
    Horton K, Juluru K, Montgomery E, Fishman E (2004) Computed tomography imaging of gastrointestinal stromal tumours with pathology correlation. J Comput Assist Tomogr 28:811–817PubMedCrossRefGoogle Scholar
  20. 20.
    Fletcher CD, Berman JJ, Corless C, et al. (2002) Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 33:459–465PubMedCrossRefGoogle Scholar
  21. 21.
    Joensuu H, Fletcher C, Dimitrijevic S, et al. (2002) Management of malignant gastrointestinal stromal tumours. Lancet Oncol 3:655–664PubMedCrossRefGoogle Scholar
  22. 22.
    Shen EF, Arnott ID, Plevris J, Penman ID (2002) Endoscopic ultrasonography in the diagnosis and management of suspected upper gastrointestinal submucosal tumours. Br J Surg 89:231–235PubMedGoogle Scholar
  23. 23.
    Okai T, Minamoto T, Ohtsubo K, et al. (2003) Endosonographic evaluation of c-kit–positive gastrointestinal stromal tumor. Abdom Imaging 28:301–307PubMedCrossRefGoogle Scholar
  24. 24.
    Chen M, Bechtold R, Savage P (2002) Cystic changes in hepatic metastases from gastrointestinal stromal tumours (GISTs) treated with Gleevec (imatinib mesylate). AJR 179:1059–1062PubMedGoogle Scholar
  25. 25.
    Reddy MP, Reddy P, Lilien DL (2003) F-18 FDG PET imaging in gastrointestinal stromal tumor. Clin Nucl Med 28:677–679PubMedCrossRefGoogle Scholar
  26. 26.
    Miettinen M, El-Rifai W, Sobin LH, Lasota J (2002) Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review. Human Pathol 33:478–483CrossRefGoogle Scholar
  27. 27.
    Blanke CD, von Mehren M, Joensuu H, et al. (2001) Evaluation of the safety and efficacy of an oral molecularly-targeted therapy, STI-571, in patients with unresectable or metastatic gastrointestinal stromal tumors (GISTS) expressing c-kit (CD117). Proc Am Soc Clin Oncol 20:1a (abstract)Google Scholar
  28. 28.
    van Oosterom AT, Judson I, Verweij J, et al. (2001) for the European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. Safety and efficacy of imatinib (STI-571) in metastatic gastrointestinal stromal tumors: a phase I study. Lancet 358:1421–1423PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • A. Darnell
    • 1
    Email author
  • E. Dalmau
    • 2
  • C. Pericay
    • 2
  • E. Musulén
    • 3
  • J. Martín
    • 1
  • J. Puig
    • 1
  • A. Malet
    • 1
  • E. Saigí
    • 2
  • M. Rey
    • 3
  1. 1.Department of RadiologyUDIAT-CD, Corporació Sanitària Parc TaulíParc Taulí s/n 08208 SabadellSpain
  2. 2.Department of OncologyCorporació Sanitària Parc TaulíParc Taulí s/n 08208 SabadellSpain
  3. 3.Department of PathologyUDIAT-CD, Corporació Sanitària Parc TaulíParc Taulí s/n 08208 SabadellSpain

Personalised recommendations