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Endoscopic Evaluation of Gastrointestinal Stromal Tumors

  • Osman Yuksel
  • William R. BruggeEmail author
Chapter
  • 768 Downloads

Abstract

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors arising from the gastrointestinal tract. GISTs can occur in any segment of the gastrointestinal tract from the distal esophagus to the anus, but they are most common in the stomach. The presence of c-KIT staining is a strong and universal marker of GISTs. Approximately 70 % patients with GISTs have some clinical symptoms, including gastrointestinal bleeding, manifested as melena, hematemesis, or bright red blood per rectum. Most GISTs are incidentally detected during endoscopic examinations. Endoscopic features are usually insufficient for the diagnosis of GISTs. Endoscopic ultrasonography (EUS) has become an important diagnostic tool for the evaluation of subepithelial lesions such as GISTs. EUS-guided sampling of GISTs is the preferred technique for histological diagnosis. The capability of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) for biopsy of GISTs is better than any other well-accepted method. The EUS-guided Tru-cut core biopsy technique provides a grossly visible sample of tissue, but it has some technical disadvantages. The curative treatment of GISTs is still complete surgical resection. However, optimal endoscopic treatment along with imatinib remains controversial. Advanced resection techniques by endoscopic devices, including endoscopic submucosal resection, endoscopic submucosal tunnel dissection, and endoscopic-laparoscopic combined approach, have been used in the treatment of GISTs.

Keywords

Gastrointestinal stromal tumor Subepithelial tumor Endoscopic ultrasonography EUS-guided fine-needle aspiration Endoscopic submucosal dissection 

Abbreviations

AGA

American Gastroenterological Association

CT

Computed tomography

ESD

Endoscopic submucosal dissection

ESMO

The European Society of Medical Oncology

ESMR

Endoscopic submucosal resection

EUS

Endoscopic ultrasonography

EUS-FNA

Endoscopic ultrasonography guided fine needle aspiration

EUS-FNB

Endoscopic ultrasonography guided fine needle biopsy

GIST

Gastrointestinal stromal tumor

MR

Magnetic resonance

NCCN

National Comprehensive Cancer Network

PDGFRA

Alpha-type platelet-derived growth factor receptor

US

Ultrasonography

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Pancreas Biliary Center, Gastrointestinal UnitMassachusetts General HospitalBostonUSA
  2. 2.Department of GastroenterologyUniversity of HacettepeAnkaraTurkey

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