GIST in A Middle-Aged Patient: Clinical Case and Review of Diagnostic and Therapeutic Approaches

Abstract

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms representing 1-2% of gastrointestinal tract tumors. They arise from the interstitial cells of Cajal, which regulate intestinal motility, and are often associated with mutations in the KIT or PDGFRA genes, making them susceptible to targeted therapy with tyrosine kinase inhibitors, such as imatinib. GISTs can occur anywhere in the gastrointestinal tract, with the stomach (60-70%) and small intestine (20-30%) being the most common sites. Clinical presentation is often nonspecific, including abdominal pain, gastrointestinal bleeding, and intestinal obstruction, which can delay diagnosis. The standard treatment for localized GISTs is complete surgical resection without lymphadenectomy due to their low metastatic potential to lymph nodes. However, for advanced or unresectable cases, imatinib therapy significantly improves patient survival. This article presents a case of GIST, highlighting its diagnosis, therapeutic approach, and clinical evolution, along with a review of current literature. The case is characterized by a fibrous mass in the colon, with histopathological confirmation of GIST and high mitotic activity, treated with imatinib as adjuvant therapy. A favorable response was observed at six months post-surgery with no recurrence or metastasis. The article discusses the current strategies for diagnosis and treatment, including the importance of surgical resection, targeted therapy, and close follow-up for early detection of recurrence.