Gastrointestinal stromal tumor history and symptoms: Difference between revisions
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{{Gastrointestinal stromal tumor}} | {{Gastrointestinal stromal tumor}} | ||
{{CMG}}{{AE}}{{ | {{CMG}}{{AE}}{{Akshun}} | ||
==Overview== | ==Overview== | ||
Obtaining [[History and Physical examination|history]] is an important aspect in making a [[diagnosis]] of gastrointestinal stromal tumors (GIST). The areas of focus should be on onset, duration, and progression of symptoms such as [[abdominal pain]], [[constipation]], change in [[appetite]], and black [[stools]]. The symptoms of GISTs depends upon the [[tumor]] size and location. Majority of the GISTs are [[asymptomatic]]. Patients with GIST who have [[Symptom|symptoms]] ([[tumor]] size > 5cm) are generally non specific such as [[dysphagia]], vague [[Abdominal discomfort|abdominal discomfort,]] [[jaundice]] and [[abdominal fullness]]. | |||
==History and Symptoms== | ==History== | ||
* [[Dysphagia]] | Obtaining [[History and Physical examination|history]] is an important aspect in making a [[diagnosis]] of GIST. It provides an insight into severity, precipitating factors and associated [[comorbid]] conditions. Complete [[History and Physical examination|history]] will help determine the correct [[therapy]] and helps in determining the [[prognosis]]. Rarely, GIST [[Patient|patients]] presenting in [[emergency room]] may be [[Disorientation|disoriented]] and the [[patient]] interview may be difficult. In such cases history from the care givers or the family members may need to be obtained. The areas of focus should be on onset, duration, and progression of [[Symptom|symptoms]] such as:<ref name="pmid22943011">{{cite journal |vauthors=Zhao X, Yue C |title=Gastrointestinal stromal tumor |journal=J Gastrointest Oncol |volume=3 |issue=3 |pages=189–208 |year=2012 |pmid=22943011 |pmc=3418531 |doi=10.3978/j.issn.2078-6891.2012.031 |url=}}</ref> | ||
* [[Gastrointestinal hemorrhage]] | *[[Abdominal pain]] | ||
* [[ | *[[Constipation]] | ||
* | *[[Appetite]] changes | ||
*Black [[stools]] | |||
*[[Hematemesis]] | |||
*Drug intake such as [[NSAIDs]] | |||
*Previous [[medical]] history (such as [[bleeding disorders]]) | |||
==Symptoms== | |||
===Common Symptoms=== | |||
* The [[Symptom|symptoms]] of GISTs depends upon the [[tumor]] size and location. | |||
* Majority of the GISTs are [[asymptomatic]]. [[Patient|Patients]] with GIST who have [[Symptom|symptoms]] ([[tumor]] size > 5cm) are generally non specific. | |||
* Following are the common [[Symptom|symptoms]] seen in [[Patient|patients]] of GIST:<ref name="pmid19248971">{{cite journal |vauthors=Quek R, George S |title=Gastrointestinal stromal tumor: a clinical overview |journal=Hematol. Oncol. Clin. North Am. |volume=23 |issue=1 |pages=69–78, viii |year=2009 |pmid=19248971 |doi=10.1016/j.hoc.2008.11.006 |url=}}</ref><ref name="pmid15648083">{{cite journal |vauthors=Nilsson B, Bümming P, Meis-Kindblom JM, Odén A, Dortok A, Gustavsson B, Sablinska K, Kindblom LG |title=Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era--a population-based study in western Sweden |journal=Cancer |volume=103 |issue=4 |pages=821–9 |year=2005 |pmid=15648083 |doi=10.1002/cncr.20862 |url=}}</ref><ref name="pmid21489899">{{cite journal |vauthors=Sandvik OM, Søreide K, Kvaløy JT, Gudlaugsson E, Søreide JA |title=Epidemiology of gastrointestinal stromal tumours: single-institution experience and clinical presentation over three decades |journal=Cancer Epidemiol |volume=35 |issue=6 |pages=515–20 |year=2011 |pmid=21489899 |doi=10.1016/j.canep.2011.03.002 |url=}}</ref><ref name="pmid15743318">{{cite journal |vauthors=Motegi A, Sakurai S, Nakayama H, Sano T, Oyama T, Nakajima T |title=PKC theta, a novel immunohistochemical marker for gastrointestinal stromal tumors (GIST), especially useful for identifying KIT-negative tumors |journal=Pathol. Int. |volume=55 |issue=3 |pages=106–12 |year=2005 |pmid=15743318 |doi=10.1111/j.1440-1827.2005.01806.x |url=}}</ref> | |||
** [[Dysphagia]] ([[esophageal]] GIST) | |||
** [[Gastrointestinal hemorrhage]] presenting with black [[stools]] or [[hematemesis]] | |||
** Vague [[abdominal pain]] or discomfort | |||
** [[Constipation]] ([[colorectal]] GIST) | |||
** [[Jaundice]] ([[Duodenum|duodenal]] GIST) | |||
** [[Abdominal fullness]] | |||
** [[Nausea]] | |||
** [[Anorexia]] | |||
** [[Weight loss]] | |||
===Less Common Symptoms=== | |||
Intra-[[abdominal]] [[hemorrhage]] is uncommon, but when it occurs, can lead to [[Symptom|symptoms]] such as:<ref name="pmid19248971">{{cite journal |vauthors=Quek R, George S |title=Gastrointestinal stromal tumor: a clinical overview |journal=Hematol. Oncol. Clin. North Am. |volume=23 |issue=1 |pages=69–78, viii |year=2009 |pmid=19248971 |doi=10.1016/j.hoc.2008.11.006 |url=}}</ref><ref name="pmid15648083">{{cite journal |vauthors=Nilsson B, Bümming P, Meis-Kindblom JM, Odén A, Dortok A, Gustavsson B, Sablinska K, Kindblom LG |title=Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era--a population-based study in western Sweden |journal=Cancer |volume=103 |issue=4 |pages=821–9 |year=2005 |pmid=15648083 |doi=10.1002/cncr.20862 |url=}}</ref><ref name="pmid21489899">{{cite journal |vauthors=Sandvik OM, Søreide K, Kvaløy JT, Gudlaugsson E, Søreide JA |title=Epidemiology of gastrointestinal stromal tumours: single-institution experience and clinical presentation over three decades |journal=Cancer Epidemiol |volume=35 |issue=6 |pages=515–20 |year=2011 |pmid=21489899 |doi=10.1016/j.canep.2011.03.002 |url=}}</ref><ref name="pmid15743318">{{cite journal |vauthors=Motegi A, Sakurai S, Nakayama H, Sano T, Oyama T, Nakajima T |title=PKC theta, a novel immunohistochemical marker for gastrointestinal stromal tumors (GIST), especially useful for identifying KIT-negative tumors |journal=Pathol. Int. |volume=55 |issue=3 |pages=106–12 |year=2005 |pmid=15743318 |doi=10.1111/j.1440-1827.2005.01806.x |url=}}</ref> | |||
*[[Malaise]] | |||
*[[Fatigue]] | |||
*[[Dyspnea]] | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]
Overview
Obtaining history is an important aspect in making a diagnosis of gastrointestinal stromal tumors (GIST). The areas of focus should be on onset, duration, and progression of symptoms such as abdominal pain, constipation, change in appetite, and black stools. The symptoms of GISTs depends upon the tumor size and location. Majority of the GISTs are asymptomatic. Patients with GIST who have symptoms (tumor size > 5cm) are generally non specific such as dysphagia, vague abdominal discomfort, jaundice and abdominal fullness.
History
Obtaining history is an important aspect in making a diagnosis of GIST. It provides an insight into severity, precipitating factors and associated comorbid conditions. Complete history will help determine the correct therapy and helps in determining the prognosis. Rarely, GIST patients presenting in emergency room may be disoriented and the patient interview may be difficult. In such cases history from the care givers or the family members may need to be obtained. The areas of focus should be on onset, duration, and progression of symptoms such as:[1]
- Abdominal pain
- Constipation
- Appetite changes
- Black stools
- Hematemesis
- Drug intake such as NSAIDs
- Previous medical history (such as bleeding disorders)
Symptoms
Common Symptoms
- The symptoms of GISTs depends upon the tumor size and location.
- Majority of the GISTs are asymptomatic. Patients with GIST who have symptoms (tumor size > 5cm) are generally non specific.
- Following are the common symptoms seen in patients of GIST:[2][3][4][5]
- Dysphagia (esophageal GIST)
- Gastrointestinal hemorrhage presenting with black stools or hematemesis
- Vague abdominal pain or discomfort
- Constipation (colorectal GIST)
- Jaundice (duodenal GIST)
- Abdominal fullness
- Nausea
- Anorexia
- Weight loss
Less Common Symptoms
Intra-abdominal hemorrhage is uncommon, but when it occurs, can lead to symptoms such as:[2][3][4][5]
References
- ↑ Zhao X, Yue C (2012). "Gastrointestinal stromal tumor". J Gastrointest Oncol. 3 (3): 189–208. doi:10.3978/j.issn.2078-6891.2012.031. PMC 3418531. PMID 22943011.
- ↑ 2.0 2.1 Quek R, George S (2009). "Gastrointestinal stromal tumor: a clinical overview". Hematol. Oncol. Clin. North Am. 23 (1): 69–78, viii. doi:10.1016/j.hoc.2008.11.006. PMID 19248971.
- ↑ 3.0 3.1 Nilsson B, Bümming P, Meis-Kindblom JM, Odén A, Dortok A, Gustavsson B, Sablinska K, Kindblom LG (2005). "Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era--a population-based study in western Sweden". Cancer. 103 (4): 821–9. doi:10.1002/cncr.20862. PMID 15648083.
- ↑ 4.0 4.1 Sandvik OM, Søreide K, Kvaløy JT, Gudlaugsson E, Søreide JA (2011). "Epidemiology of gastrointestinal stromal tumours: single-institution experience and clinical presentation over three decades". Cancer Epidemiol. 35 (6): 515–20. doi:10.1016/j.canep.2011.03.002. PMID 21489899.
- ↑ 5.0 5.1 Motegi A, Sakurai S, Nakayama H, Sano T, Oyama T, Nakajima T (2005). "PKC theta, a novel immunohistochemical marker for gastrointestinal stromal tumors (GIST), especially useful for identifying KIT-negative tumors". Pathol. Int. 55 (3): 106–12. doi:10.1111/j.1440-1827.2005.01806.x. PMID 15743318.