Management of hemorrhage in gastrointestinal stromal tumors: a review

Abstract

Gastrointestinal stromal tumors (GISTs) are relatively common mesenchymal tumors. They originate from the wall of hollow viscera and may be found in any part of the digestive tract. The prognosis of patients with stromal tumors depends on various risk factors, including size, location, presence of mitotic figures, and tumor rupture. Emergency surgery is often required for stromal tumors with hemorrhage. The current literature suggests that stromal tumor hemorrhage indicates poor prognosis. Although the optimal treatment options for hemorrhagic GISTs are based on surgical experience, there remains controversy with regard to optimum postoperative management as well as the classification of malignant potential. This article reviews the biological characteristics, diagnostic features, prognostic factors, treatment, and postoperative management of GISTs with hemorrhage.

Keywords: GIST; hemorrhage of digestive tract; prognosis; targeted therapy.

Figure 1

Endoscopic manifestation of GIST with ulceration and active bleeding. Abbreviation: GIST, gastrointestinal stromal tumor.

Figure 2

The enhanced-contrast CT image of a GIST with hemorrhage: the typical “air sign” is caused by hemorrhage and necrosis of the tumor. Abbreviation: GIST, gastrointestinal stromal tumor.