Stromal tumor (gist) at the angle of Treitz

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Jeremy Marchal(1), Zaynab Ouadi(1), Benjamin Alexandre(2), Aude Schillaci(1), Didier Deltour(1) Published in the journal : November 2017 Category : Gastroenterology

Summary :

GIST are rare mesenchymal tumors, and their pre-operative diagnosis may prove challenging. This can be accounted for by less accessible anatomical localizations, and particularly the duodenum and angle of Treitz, in addition to the fact that the biopsies obtained may turn out to be poorly contributory. Surgical intervention that usually allows for a formal diagnosis remains the cornerstone of treatment. When a GIST is suspected, surgery must be encouraged and this, even in the absence of histologically confirmed disease.

What is already known about the topic?

- Rare tumors

- Pre-operative diagnosis may prove at times difficult (non-contributory biopsies, difficult access, etc.)

- Surgery is the reference treatment

- (Neo)adjuvant therapies like imatinib are available, but require formal diagnosis

What does this article bring up for us?

- Surgery can be both a diagnostic and therapeutic tool

- The surgical approach should be encouraged when a formal diagnosis is not obtained, even in the likely presence of resectable metastatic lesions

Key Words

Duodenal gist, gastrointestinal stromal tumor, diagnosis, biopsy, surgery, segmental resection