Diagnostic difficulties in patients with gastrointestinal stromal tumour

Gastrointestinal stromal tumours are a rare mesenchymal neoplasm occurring within the abdominal cavity. Preoperative diagnosis is difficult despite numerous diagnostic examinations. Aim: To analyze diagnostic difficulties in patients with gastrointestinal stromal tumour. Materials and methods: Between 1989 and 2005, 31 patients with primary gastrointestinal stromal tumour were treated. Mean age of patients was 61.5 years. 64% were women and 36% men. Results: Preoperative evaluation in patients with symptomatic GIST included gastrointestinal endoscopy (73%), abdominal ultrasonography (73%), computed tomography (54%) and barium examination (23%). The histologic diagnosis was established only in one case (4%) before operation. Abdominal US and CT revealed correct location of the GIST, respectively in 8% and 58%. Gastric and small intestine stromal tumours were interpreted incorrectly as pancreatic tumour or cyst, colon tumour and periappendiceal phlegmon. Conclusions: Diagnostic difficulties in patients with GIST are related to some specific morphological features of the neoplastic tumour. Most symptomatic gastrointestinal stromal tumours are easily revealed in imaging examinations, but it is often difficult to define the organ from which GIST originates. Abdominal computed tomography is the best imaging examination in GISTs. Preoperative histopathologic diagnosis of GIST is seldom possible.