Gastrointestinal stromal tumors of the colon and rectum

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. GISTs of the colon and rectum are rare, comprising 5% of all cases. There are few data available for colorectal GISTs to guide management. Although they can be small and found incidentally, the majority appear to be at high risk and carry a worse prognosis than gastric GISTs. Surgery remains the mainstay of treatment for primary disease. GISTs are targeted effectively with tyrosine kinase inhibitors (TKIs) such as imatinib mesylate. GISTs are best treated by a multidisciplinary team comprising the surgeon, medical oncologist, pathologist, and radiologist; this approach has the potential benefits of increasing the number of resectable cases through neoadjuvant treatment, optimizing the timing of surgery and organ preservation, reducing recurrence and surgical morbidity, and prolonging survival. On completion of this article, the reader should be able to summarize the diagnosis, specific characteristics, and management of gastrointestinal stromal tumors of the colon and rectum.