Abstract:Objective:To study the diagnosis and treatment of small intestinal stromal tumor(SIST).
Methods:We retrospectively analysed the clinical information of 32 patients with SIST.
Results:The average onset age of the patients was 52.8 years. The main clinical manifestations were dark stools, abdominal pain, abdominal mass, abdominal distention, fever, debilitation, anaemia, and loss of body weight. The tumors were located in jejunum in 26 cases, in ileum in 5 cases, and 1 patient had multiple tumors in both jejunum and ileum. The abdominal mass was discovered by B-ultrasonography in 12 patients. Among the 12 cases, 4 cases were diagnosed with the tumor located in intestinal tract, in 5 cases the origin of the tumor could not be determined, and 3 cases were misdiagnosed as tumor of the ovary. Tweenty patients who received CT scan were all discovered to have primary tumors or metastatic lesions. The CT positive detection rate was 100%, and 15 of the tumors were confirmed to be located in intestinal tract (75%). In 6 of 8 patients,the intestinal tumors were discovered by digital subtraction angiography (DSA); 5 patients were diagnosed with intestinal tumor by small intestinal endoscopy. There were no positive findings in the 4 patients who received radiographic studies of digestive tract. All patients received surgical operation. Their diagnosis was confimed as stromal tumor by pathology and immunohistochemistry. Tweenty-two patients were followed up from 6 months to 5 years, 4 patients had recurrence, 2 hepatic metastasis, and 2 died.
Conclusions:stromal tumor of jejunoileum lacks distinctive clinical manifestations, CT and DSA can be of benefit in diagnosis, and small intestinal endoscopy is an effective way for diagnosis. Operation and molecular targeted therapy are effective treatment of SIST.