Săvulescu F. 1, Duțu C. 1, Trifu V. 2, Dărmănescu Monica 2, Surdeanu D. 1, Merticariu B. 1, Cirlan C. 1
1 Central Military Emergency University Hospital Second Surgical Department, Bucharest, Romania
2 Central Military Emergency University Hospital Dermatology Department, Bucharest, Romania
Abstract
Even if they have a low incidence (0.1-3% of gastrointestinal tumours), the stromal tumours located in the digestive tract raise important issues in predicting the risk of recurrence. Their diagnosis and treatment have evolved over the last 20 years, particularly in etiopathogenic terms, due to the arsenal of laboratory investigations like imunohistochemistry and mutational analysis techniques. The main factors that determine the risk of recurrence, initially evaluated by Mietinen (2006) and subsequently clarified by Joensuu (2008, 2011) are the size, the number of mitoses, the tumour location and the intrusion capsule. The main pillars of treatment are surgery and therapy with Imatinib. Three representative cases for the factors described and well coded as diagnosis, treatment and postoperative monitoring are presented in this article: a bulky gastric tumour and one giant gastric intestinal (resected by laparotomy) and cecal gastrointestinal stromal tumour (GIST) (rarerly concerning the location) incidentally discovered during an appendectomy, laparoscopically resolved. The review of literature in this field combined with the clinical experience highlight the characteristics of these tumours, and, ultimately, guide the therapeutic approach in similar situations.