Preoperative histopathological diagnosis of GIST by mucosal cutting biopsy followed by LECS treatment

Abstract

A 70-year-old woman was referred to our hospital for further examination of gastric submucosal tumor (SMT). Esophagogastroduodenoscopy (EGD) revealed the SMT to be approximately 20 mm in diameter and situated on the middle body anterior wall of the lesser curvature, which was steep-sided and covered with normal mucosa. EUS showed the lesion to extend continuously into the fourth layer of the gastric mucosa, with a fairly homogeneous echogenicity. Due to an increase in size of the SMT, we performed an endoscopic mucosal cutting biopsy. The histopathological findings indicated a spindle cell tumor with no mitotic figures. GIST was diagnosed on the basis of positive immunostaining for c-kit and CD34. The patient also underwent laparoscopic and endoscopic cooperative surgery (LECS) in accordance with published therapeutic guidelines for GIST.
The histopathological and immunostaining findings from surgically resected specimens were in agreement with those from the mucosal cutting biopsy specimens.
It is vital to diagnose GIST early, as small lesions are resectable by LECS. Biopsy with incision of the mucosa is useful for early diagnosis of SMT.