Gastrointestinal stromal tumour — Evolving concepts

Introduction: GISTs are rare tumours of the gastrointestinal tract constituting less than 1% of all primary neoplasms. They remain the commonest mesenchymal tumours of the gut. Historically they have been confused with more common tumours of smooth muscle and neurogenic origin because they share their histological features. Only in the past two decades has the identification of immunohistochemistry marker CD 117 (c-kit) greatly enhanced their diagnosis. Considerable perplexity surrounds prediction of their malignant potential because the predictive factors used can only make an approximate measurement of their behaviour. Methods: Medline Pubmed and Cochrane database searches were performed and the articles found were cross referenced. Conclusion: GIST has an estimated annual incidence of 12–14 per million population. Stratifying into risk group remains important for prognosis and planning further follow-up. Complete excision (Ro) remains the mainstay curative treatment. Previous dismal prognosis of recurrent or metastatic disease has only recently been improved by introduction of targeted molecular anti-receptor therapy by imatinib.