Gastrointestinal Stromal Tumors: Current Concepts and Controversies

摘要

A large number of mesenchymal lesions can occur in the gastrointestinal tract. Stromal tumors represent the most important category of these lesions and have been a source, of controversy in regards to classification, histogenesis/ differentiation and perhaps most important, determination of biologic potential. Recently with the advent of new therapeutic interventions, proper characterization and con ceptualization of these tumors has acquired a new meaning, and, emphasis is being placed on the role that various diagnostic techniques play in the evaluation of these neo plasms. The information that has become available is still in the process of being collated and expert opinions vary according to their own biases. There is" no consensus of opinion in some very important and fundamental issues. While most of the issues pertaining to stromal gastrointes- tinal tumors may eventually be clarified with well-designedstudies addressing the controversies, it may lake quite some time before this happens and proper climco-pathologic, testing of the conclusions is completed. In the meantime, these neoplasms need to be carefully examined pathologi cally in a way that clinically relevant information is obtained, to be conveyed to the clinicians. The challenge today remains to .decide how these stromal tumors should be worked up by surgical pathologists and reported to the clinicians to manage their patients appropriately. This arti- cle will address some of the important issues that remain unsettled. In this article, two representative cases will be illustrated to highlight a practical approach to address issues pertaining to gastrointestinal stromal tumors.