Gastrointestinal stromal tumor historical perspective

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  • Earlier gastrointestinal stromal tumors were classified as smooth muscle tumors such as leiomyomas or leiomyosarcomas. However, with the use of electron microscopy gave little evidence in the favour of smooth muscle cells as origin of GIST.
  • In 1980s, the use of immunohistochemistry and immunotyping further suggested that GIST arise from antigens related to neural crest cells.

In 1983, Mazur and Clark and Schaldenbrand and Appleman in 1984 were the first to describe gastrointestinal stromal tumors as an independent entity.

  • In 1998, Kindblom et al described the origin of GIST as pluripotential mesenchymal stem cells which were programmed to differentiate into the interstitial cell of Cajal. [1]
  • Additional studies have shown that interstitial cells of Cajal express KIT and their development depends upon stem cell factor, which is regulated through KIT kinase.
  • In 1998 Hirota and others were the first to describe c-kit (proto-oncogene) mutations as the cause of GIST.[2]
  • Recent advances in molecular genetics have to led to classification of GIST based on gene type and development of molecular-targeted therapy.
  • In 2001, Joensuu was the first to report successful treatment of a patient with advanced GIST on molecular-targeted therapy (imatinib).



The term gastrointestinal stromal tumors was initially coined as a purely descriptive term by Mazur and Clark in 1983 to define intra-abdominal tumors that were not carcinomas (i.e., nonepithelial tumors) and that also did not exhibit histologic features of smooth muscle or nerve cells.[3]


References

  1. Kindblom LG, Remotti HE, Aldenborg F, Meis-Kindblom JM (1998). "Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal". Am. J. Pathol. 152 (5): 1259–69. PMC 1858579. PMID 9588894.
  2. Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, Kawano K, Hanada M, Kurata A, Takeda M, Muhammad Tunio G, Matsuzawa Y, Kanakura Y, Shinomura Y, Kitamura Y (1998). "Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors". Science. 279 (5350): 577–80. PMID 9438854.
  3. Mazur MT, Clark HB (1983). "Gastric stromal tumors. Reappraisal of histogenesis". Am. J. Surg. Pathol. 7 (6): 507–19. PMID 6625048.


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