Tumorile gastrointestinale stromale gastrice gigante

Background. Gastrointestinal stromal tumors (GIST) represent 0.1-3% of all mesenchymal neoplasms of the gastrointestinal tract and giant gastric (GG) GIST are rare. Objective of the study. Study of clinical, histopathological and immunohistochemical features and treatment results of GG GIST. Material and Methods. 92 patients with GG GIST(c-kit(CD117)(+) treated between 2007-2019. Study group–14 patients with GG GIST, M:F=1.8:1, mean age-59.78±2.35(95%CI:54.69-64.87) years. Results. Surgical options: excision of gastric tumor-2(14,3%), gastric wedge resection-7(50%), partial gastrectomy-5(35,7%). The mean maximum size of tumors 23,69±0,81(95%CI:21,93-25,44)cm. Immunohistochemical phenotype: CD117(+)–14(100%), CD34(+)–12(85.7%), desmin(+)–3(21.4%), vimentin(+)–10(71.4%), S-100(+)–3(21.4%), SMA(+)–8(57.1%), NSE–2(14.3%). Mean number of mitoses–24.36±6.3(95%CI:10.65-38.06). Tumors with high mitotic count were registered more frequent than with low mitotic count–11(78.6%) vs. 3(21.4%)(p<0.05). Metastases at first presentation– 28.6%(n=4) cases. Complex treatment – surgical and target therapy with imatinib mesylate–14(100%) patients. Conclusion. GG GIST are rare, but possess a higher risk of progression. Complex treatment is the best curative option. Introducere. Tumorile gastrointestinale stromale (TGIS) reprezintă 0,1-3% din neoplaziile mezenchimale ale tractului digestiv. TGIS gastrice gigante (GG) se întâlnesc rar. Scopul lucrării. Analiza particularităților clinice, a aspectelor histopatologice, imunohistochimice și a rezultatelor tratamentului TGIS GG. Material și Metode. 92 de pacienți cu TGIS GG (c-kit(CD117)(+) operați între 2007-2019. Lotul de cercetare–14 pacienți cu TGIS GG, raportul femei:bărbați– 1:1,8, vârsta medie 59,78±2,35 ani. Rezultate. Volumul operațiilor: excizia tumorii peretelui gastric– 2(14,3%), rezecție gastrică limitată–7(50%), gastrectomie subtotală–5(35,7%). Dimensiunea maximă în medie a tumorilor 23,69±0,81 cm. Profilul imunohistochimic al tumorilor: CD117(+)–14(100%), CD34(+)–12(85,7%), desmină(+)–3(21,4%), vimentină(+)–10(71,4%), S-100(+)–3(21,4%), SMA– 8(57,1%), NSE–2(14,3%). Numărul mediu al mitozelor– 24,36±6,3(95%CI:10,65-38,06). Tumorile cu indice mitotic înalt au predominat asupra tumorilor cu indice mitotic redus– 11(78,6%) vs. 3(21,4%)(p<0,05). Metastaze la adresarea primară– 28,6%(n=4) cazuri. Tratament combinat – chirurgical și target terapie cu imatinib mesilat– 14(100%) pacienți. Concluzii. TGIS gastrice gigante sunt rare, dar frecvent cu risc înalt de progresare. Tratamentul combinat este opțiunea curativă optimă

Giant gastric gastrointestinal stromal tumors

Department of gastric surgery, Department of Melanoma, Oncological Institute from Moldova, First Department of Surgery “N. Anestiadi” and Laboratory of Hepato-pancreato-biliary Surgery, SUMPh "N.Testemitanu", Institute of Emergency Medicine, Department of oncology, SUMPh "N.Testemitanu", Chișinău, Moldova, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction: Gastrointestinal stromal tumors (GIST) represent 0.1-3% of all mesenchymal neoplasms of the gastrointestinal tract and giant gastric (GG) GIST are rare. Purpose: Study of clinical, histopathological and immunohistochemical features and treatment results of GG GIST. Material and methods: 92 cases with GG GIST (c-kit(CD117)(+) treated between 2007-2019. Conclusions: GG GIST are rare, but possess a higher risk of progression. Complex treatment is the best curative option. Keywords: giant GIST, complex treatment, high risk. Results: A review of the database of 92 gastric GIST patients with positivity to the specific marker c-KIT(CD117) was performed. The study group consisted of 14 patients with GIST of the stomach. M:F=1.8:1. Mean age-59.78±2.35 years. Surgical options: excision of gastric tumor-2 (14,3%), gastric wedge resection - 7 (50%), partial gastrectomy - 5 (35,7%). The mean maximum size of tumors was 23.69±0.81 cm. Immunohistochemical phenotype: CD117(+)-14(100%), CD34(+) -12(85.7%), desmin(+)-3(21.4%), vimentin(+)-10(71.4%). Mean number of mitoses–24.36±6.3. Tumors with high mitotic count were registered more frequent than with low mitotic count – 11(78.6%) vs. 3(21.4%) (p<0.05). Metastases at first presentation – 28.6%(n=4) cases. Complex treatment – surgery and imatinib mesylate–in 14(100%) patients. Conclusions: GG GIST are rare, but possess a higher risk of progression. Complex treatment is the best curative option