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KMID : 0388420040140010201
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Konkuk Journal of Medical Sciences
2004 Volume.14 No. 1 p.201 ~ p.208
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A Case of Large Gastrointestinal Stromal Tumor of Stomach
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Lee Kyung-Yung
Yoo Young-Bum
Kim Tae-Won
Lee Kyeong-Ryong
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Abstract
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Gastrointestinal tumors(GIST) are rare group of neoplasias of the gastrointestinal track, which originate from or differentiate into interstitial cells of Cajal (ICC). GIST traditionally have been designated as smooth muscle tumor. However, with increasingly accurate analytic tools, immunohistochemistry and ultrastructure, most investigators were able to demonstrate that ICC, a complex cellular network postulated to act as pacemaker cells of the gastrointestinal track, which exhibit both myoid and neural features, could be a candidate for tumor histogenesis. Most ICC are only c-kit-positive, however a subset are positive for both c-kit and CD34. Most GISTs are asymptomatic and are thus usually discovered incidentally during routine check, at operation of other organs.
When symptoms occur, GISTs usually present with gastrointestinal bleeding due to ulceration of the overlying gastric mucosa. Bleeding may be massive, leading to hematemesis and melena. Recently, we experienced a large sized(5×5×5 cm) GIST on the upper body of the stomach, which caused massive upper gastrointestinal bleeding in a 61-year-old man and was treated by local resection with adequate safety margin about 2 cm.
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KEYWORD
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Gastrointestinal stromal tumor, Interstitial cells of Cajal(ICC), c-kit CD34, CD34
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