GISTs revealing their secrets

Congress:

ECR 2020

Poster Number:

C-10711

Type:

Educational Exhibit

Keywords:

Not applicable, Tissue characterisation, Pathology, Surgery, Diagnostic procedure, MR, CT, Gastrointestinal tract, Abdomen, GI Tract

Authors:

M. KASSIMI, H. GUERROUM, J. HABI, N. Chikhaoui, M. Mahi; Casablanca/MA

DOI:

10.26044/ecr2020/C-10711

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-10711

Fig. 1: A,B,C :Gastric GIST In sagittal,coronal and axial contrast-enhanced CT,...

Fig. 2: 56 years old male, unexplained anemia, Duodenal GIST dependant of the lower...

Fig. 3: Rectal GIST :Female, 52years old , who suffered from rectal bleeding Pelvic...

Fig. 4: Male ,54ans ,renitent mass in rectal examination . Rectal GIST seen in...

Learning objectives

To Illustrates various patterns of presentation (typical and atypical) of gastrointestinal stromal tumors (GISTS) on imaging. To list the key points that can guide radiologists towards the diagnosis of GISTS.

Background

Gastrointestinal stromal tumors are the most common mesenchymal neoplasm of the gastrointestinal tract.They arise from the interstitial cells of Cajal .This cells normally express cKIT (CD 117), which is a tyrosine kinase growth factor receptor. C-KIT immunoreactivity is considered the most specific criterion for the diagnosis of GIST distinguishing them from true smooth muscle tumors (leiomyomas and leiomyosarcomas) and tumors arising from neural crest derivatives (schwannomas and neurofibromas), GISTs can occur anywhere along the GI tract. The most common site of GISTs is the stomach...

Findings and procedure details

The reported age of presentation is 40–70 years old, with an equal male-to-female ratio. The most common presenting symptom includes abdominal pain or a palpable mass, followed by a GI bleed, unexplained anemia, fatigue and malaise. The aim of imaging is to locate the lesion, define its morphological characteristics, evaluate local invasion and detect distant metastasis. CT is the imaging modality of choice for diagnosing GIST at initial presentation, staging and monitoring the disease during and after the treatment. MRI is particularly useful in cases...

Conclusion

GIST exhibits a wide range of clinical presentations and imaging characteristics. In order to a correct diagnosis and to take active participation in patient management and treatment options, radiologist should become familiar with the most typical radiological pitfalls of the diagnosis of GISTs.

Personal information and conflict of interest

N. Chikhaoui; Casablanca/MA - nothing to disclose M. Kassimi; Casablanca/MA - nothing to disclose H. Guerroum; Casablanca/MA - nothing to disclose J. Habi; Casablanca/MA - nothing to disclose M. Mahi; Casablanca/MA - nothing to disclose

References

Chen, Z., Yang, J., Sun, J., & Wang, P. (2020). Gastric gastrointestinal stromal tumours (2-5 cm): Correlation of CT features with malignancy and differential diagnosis. European Journal of Radiology, 123, 108783. doi:10.1016/j.ejrad.2019.108783 Gastrointestinal stromal tumors (GISTs): An imaging perspective ;Jpn J Radiol (2012) 30:105–115 Hyunseon C. Kang, et al. Beyond the GIST: Mesenchymal Tumors of the Stomach. RadioGraphics 2013; 33:1673-1690 Kim SW, Kim HC, Yang DM, Won KY. Gastrointestinal stromal tumours (GISTs) with a thousand faces: atypical manifestations and causes of misdiagnosis on imaging. Clin...