Diagnosis: Gastrointestinal stromal tumor (GIST tumor)
Findings on Imaging:
- On upper GI series, any filling defects projecting from the wall of the stomach may be seen. Ulceration and cavitation may also be present. Margins of the filling defect may be smooth or irregular.
- Fluoroscopy of the upper gastrointestinal tract shows an elevated, well-circumscribed mass in the stomach.
- The mass appears to arise from the muscularis propria layer of the stomach wall, which is a common location for GIST tumors.
- The mass is irregularly shaped and has an appearance consistent with a GIST tumor.
- The GIST tumor appears to be causing some luminal obstruction, as there is delayed passage of contrast material through the stomach.
Next Steps in Management:
- Biopsy of the GIST tumor is recommended to confirm the diagnosis and assess for the presence of high-risk features, such as mitotic rate and tumor size.
- Treatment options for GIST tumors include surgical resection and targeted therapy with medications such as Gleevec (imatinib).
- Regular imaging follow-up is necessary to monitor for tumor recurrence or progression.
Key Take Away Points:
- GIST tumors are rare tumors that can arise anywhere along the gastrointestinal tract, but most commonly occur in the stomach.
- Fluoroscopy can be a useful imaging modality for identifying the presence and location of a GIST tumor in the gastrointestinal tract.
- Biopsy is necessary to confirm the diagnosis of a GIST tumor and assess for high-risk features that may impact treatment decisions.
- Treatment options for GIST tumors may include surgery and targeted therapy with medications such as Gleevec.
- Regular imaging follow-up is necessary to monitor for tumor recurrence or progression, as GIST tumors can have unpredictable behavior.
Credit: Case submitted by Dr. Saeed Rad, MD to radRounds Radiology Network