Watch more on
on YouTube
Gastrointestinal Stromal Tumours (GIST)
Symptoms, Diagnosis and Treatment
What Are Gastrointestinal Stromal Tumours (GIST)?
Gastrointestinal stromal tumours (GIST) are rare tumours that develop within the gastrointestinal (GI) tract. They can occur anywhere along the digestive system, including the stomach, small intestine and other parts of the GI tract.
However, they are most commonly found in the stomach.
GIST tumours occupy an intermediate position between benign growths and malignant cancers. Although they are not the same as typical stomach cancer, they do have the potential to grow and become more aggressive over time if left untreated.
For this reason, early diagnosis and appropriate treatment are important.
Where Do GIST Tumours Occur?
GIST tumours can arise in several parts of the digestive system, including:
-
The stomach (most common location)
-
The small intestine
-
The oesophagus
-
Other areas of the gastrointestinal tract
Many GIST tumours are discovered incidentally during scans performed for unrelated medical reasons.
Symptoms of GIST Tumours
In some cases, GIST tumours may not cause symptoms initially. However, when symptoms do occur they may include:
-
Gastrointestinal bleeding
-
Vomiting blood
-
Black, tarry stools
-
Abdominal pain or pressure
-
Symptoms caused by the tumour increasing in size and pressing on nearby organs
Bleeding from the stomach is one of the more common ways these tumours may present.
How Are GIST Tumours Diagnosed?
When a suspected GIST tumour is identified, patients are usually discussed in a multidisciplinary team (MDT) meeting involving specialists from surgery, oncology, radiology and pathology.
The diagnostic process often includes:
-
Imaging scans
-
Endoscopy
-
Biopsy of the tumour
If the biopsy confirms a GIST tumour, the sample is typically sent for mutation analysis. This analysis helps determine which targeted medications may be most effective for the tumour.
Treatment for GIST Tumours
In most cases, the primary treatment for GIST tumours is surgical removal of the tumour.
GIST tumours can grow either:
Inwards into the stomach, or
Outwards from the stomach wall
Regardless of the direction of growth, many of these tumours can be removed using modern surgical techniques.
Surgical Options for GIST
The type of surgery used depends largely on the size and location of the tumour.
Possible approaches include:
Robotic surgery
Robotic surgery allows surgeons to perform procedures with enhanced precision and improved visualisation.
Laparoscopic (keyhole) surgery
Minimally invasive laparoscopic techniques use small incisions and specialised instruments to remove the tumour.
Open surgery
For very large tumours, an open surgical approach may be necessary to remove the tumour safely in one piece.
The decision regarding which technique to use depends on the tumour’s size and anatomical position.
Size of the Tumour and Surgical Approach
Smaller GIST tumours — typically around 5 to 6 centimetres — may often be removed using laparoscopic or robotic techniques.
In these cases, one of the small incisions may be slightly enlarged to allow the tumour specimen to be removed safely.
Very large tumours may require an open operation, as removing the tumour intact is essential.
Risk of Recurrence After Surgery
After removal, the tumour is analysed by pathologists to determine the risk of recurrence.
Tumours are generally classified into two groups:
-
Low risk of recurrence
-
High risk of recurrence
This classification depends on factors such as the size of the tumour and its microscopic features.
Follow-Up and Additional Treatment
Patients with low-risk tumours may require only regular follow-up scans after surgery.
Patients with high-risk tumours may be advised to take a targeted medication tablet for several years in order to reduce the risk of the tumour returning.
Regular monitoring remains an important part of long-term care.
Specialist Surgical Care
Mr Ash Rohatgi is a Consultant Upper GI and Laparoscopic Surgeon in London with experience in the diagnosis and surgical treatment of gastrointestinal stromal tumours and other upper gastrointestinal conditions.
His approach combines careful assessment, multidisciplinary collaboration and modern surgical techniques to provide the most appropriate treatment for each patient.
Patients experiencing unexplained gastrointestinal bleeding, abdominal pain or digestive symptoms may benefit from specialist evaluation to determine the underlying cause.
