Soft tissue sarcoma

Soft tissue sarcoma

Gastrointestinal stromal tumor (GIST)

A gastrointestinal stromal tumor (GIST) is a type of cancer that begins in the digestive system. GISTs most commonly occur in the stomach and small intestine.

A GIST is a growth of cells that is thought to form from a special type of nerve cell. These special nerve cells are located in the walls of the digestive organs. They play a role in the process that moves food through the body.

Small GISTs may not cause symptoms and may grow so slowly that they do not cause problems at first. As a GIST grows, it can cause signs and symptoms. These could include:

• Bauchschmerzen
• Eine Wucherung, die Sie in Ihrem Bauch spüren können
• Ermüdung
• Brechreiz
• Erbrechen
• Krampfschmerzen im Unterleib nach dem Essen
• Kein Hungergefühl, wenn man es erwarten würde
• Völlegefühl, wenn Sie nur eine kleine Menge essen
• Dunkel gefärbter Stuhl, verursacht durch Blutungen im Verdauungssystem

GISTs can occur in people of all ages, but they are most common in adults and very rare in children. The cause of most GISTs is not known. A small number are caused by genes passed from parents to children.

diagnosis

To diagnose a GIST, your doctor might first ask you about your symptoms and health. Your provider may also check for a growth in your abdomen.

If symptoms suggest you may have a GIST, you may need other tests to find the tumor. These tests may include:

• Bildgebende Tests. Bildgebende Tests helfen Ihrem Gesundheitsteam, Ihren Tumor zu finden und seine Größe zu sehen. Die Tests können Ultraschall-, CT-, MRT- und Positronen-Emissions-Tomographie (PET)-Scans umfassen. Nicht jeder braucht jeden Test.
• Obere Endoskopie. Bei diesem Test wird ein langer, dünner Schlauch (Endoskop) mit einem Licht am Ende verwendet. Der Schlauch geht durch den Mund und den Hals hinunter. Dieser Test untersucht das Innere der Speiseröhre, des Magens und des ersten Teils des Dünndarms.
• Endoskopischer Ultraschall (EUS). Bei diesem Test wird ebenfalls ein Endoskop verwendet, jedoch mit einer Ultraschallsonde an der Spitze des Endoskops. Die Ultraschallsonde verwendet Schallwellen, um Bilder des Tumors zu machen und seine Größe anzuzeigen.

• Fine needle aspiration biopsy.This test involves removing a small sample of tissue from the tumor so that it can be tested in a laboratory. This test is like EUS, but with a thin, hollow needle at the tip of the endoscope. The EUS finds the tumor. The needle collects small amounts of tissue for laboratory testing.

  Sometimes the needle can't get enough cells or the results aren't clear. You may need surgery to collect the sample.

• Laboruntersuchungen an Biopsien. Die Biopsieprobe Ihres Tumors geht zum Testen in ein Labor. Im Labor testen Spezialisten die Zellen, um festzustellen, ob es sich um Krebszellen handelt. Andere Tests liefern Ihrem Anbieter Informationen über Ihre Krebszellen, die zur Planung Ihrer Behandlung verwendet werden.

Treatment

GIST treatment often includes surgery and targeted therapy. Which treatments are best for you depends on your situation.

Some GISTs do not require immediate treatment. Very small GISTs that do not cause symptoms may not need treatment. Instead, you could have tests done to see if the cancer is growing. If your GIST grows, you can begin treatment.

surgery

The goal of the surgery is to remove all of the GIST. It is often the first treatment for GISTs that have not spread to other parts of the body.

Surgery may not be necessary if your tumor becomes very large or grows into nearby structures. In this case, your first treatment might be targeted drug therapy to shrink the tumor. You could have surgery later.

The type of surgery you have depends on your cancer. Surgeons can often access the GIST in a minimally invasive manner. This means that surgical instruments are passed through small incisions in the abdomen rather than one large incision.

Targeted drug therapy

Targeted drug treatments focus on specific chemicals present in cancer cells. By blocking these chemicals, targeted drug treatments can cause cancer cells to die. For GISTs, the target of these drugs is an enzyme called tyrosine kinase, which helps cancer cells grow.

Targeted drug therapy for GIST often begins with imatinib (Gleevec). Targeted drug treatments can be given:

• Nach der Operation, um das Risiko zu verringern, dass der Krebs zurückkommt
• Vor der Operation, um den Tumor zu verkleinern und leichter entfernen zu können
• Als Erstbehandlung, wenn sich der Krebs auf andere Teile des Körpers ausgebreitet hat
• Wenn der GIST zurückkommt

Other targeted medications may be used if imatinib does not work or has stopped working for you. Targeted drug therapy is an active area of ​​cancer research, and new drugs are likely to become options in the future.

Sources:

1. Feldman M. et al., Hrsg. Magen-Darm-Stroma-Tumoren. In: Gastrointestinale und Lebererkrankungen von Sleisenger und Fordtran: Pathophysiologie, Diagnose, Management. 11. Aufl. Elsevier; 2021. https://www.clinicalkey.com. Abgerufen am 8. Dezember 2021.
2. Gastrointestinale Stromatumoren (GISTs). Nationales umfassendes Krebsnetzwerk. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1507. Abgerufen am 8. Dezember 2021.
3. Goldblum JR, et al. Gastrointestinaler Stromatumor (GIST) und extragastrointestinaler GIST. In: Weichteiltumoren von Enzinger und Weiss. 7. Aufl. Elsevier; 2020. https://www.clinicalkey.com. Abgerufen am 8. Dezember 2021.