A gastrointestinal stromal tumor, (GIST), is a type of growth that is usually benign, (non-cancerous), that is present in the stroma, a layer of connective tissue in the wall of the stomach or the intestine. These tumors are most often found in the stomach, or the first part of the small intestine, but any part of the GI tract can be affected. Although classified as benign, it appears that some GISTs, can become malignant, invading, and spreading to other tissues. The risk of a GIST becoming malignant is related to its size and location. Larger GISTs are more likely to become malignant and GISTs on the stomach are less likely, compared to GISTs in other areas of the intestinal tract.
GISTs make up only 1% of cancers starting in the GI tract. It is thought to affect 7-20 people per one million in the United States each year. It occurs most often in middle-aged and older people and is rare in people under 40. No risk factors for GISTs have been identified.
Sometimes, this condition has no symptoms, and the presence of the GIST is found incidentally on an upper endoscopy, barium study, or CT scan done for other purposes. They are often associated with non-specific symptoms such as:
If the mass grows large enough it can ulcerate or cause obstruction of the bowel. If this happens, other symptoms are possible and include:
With or without endoscopic ultrasound
Treatment depends on the size and the location of the GISTs. Often if 2 cm in size or larger, they will be surgically removed. Sometimes treatment will begin with chemotherapy to shrink the tumor size or stop its growth before surgery. Other times, chemotherapy will be used alone. Chemotherapy targets the production of the signal that is leading to the rapid cell growth and cell division in the tumor.
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