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obsolete stromal neoplasm

Description

Based on the provided context, it appears that there are various types of stromal neoplasms mentioned, including those that are considered obsolete or rare.

Definition and Characteristics

A stromal neoplasm is a type of tumor that arises from the stromal cells of an organ. These tumors can be benign or malignant and can occur in various parts of the body, including the uterus, ovaries, and testes.

  • Epithelial Neoplasm (Antiquated): This term refers to a type of stromal neoplasm that is considered obsolete. It was previously used to describe a tumor that arose from the epithelial cells of an organ, but it is no longer a recognized classification.
  • Benign Stromal Tumors: These are rare tumors that arise from the stromal cells of an organ and are typically non-cancerous.

Types of Stromal Neoplasms

There are several types of stromal neoplasms mentioned in the context, including:

  • Gastrointestinal Stromal Tumors (GISTs): These are rare tumors that arise from the stromal cells of the digestive tract.
  • Endometrial Stromal Sarcomas: These are rare cancers that arise from the stromal cells of the uterus.
  • Sclerosing Stromal Tumors: These are rare benign ovarian neoplasms that occur predominantly in young women.

Key Points

  • Stromal neoplasms can be benign or malignant and can occur in various parts of the body.
  • GISTs, endometrial stromal sarcomas, and sclerosing stromal tumors are examples of types of stromal neoplasms.
  • These tumors are rare and often have distinct characteristics.

References:

[1] Context 1: Very Low Risk Gastric Gastrointestinal Stromal Tumor [2] Context 2: Tumor necrosis and >20 mitoses per 50 high-power fields can distinguish 'very high-risk' and 'highest-risk' within 'high-risk' gastric gastrointestinal stromal ... [3] Context 3: Gastrointestinal stromal tumors (GIST) are of mesenchymal origin and belong to the rare malignant tumors. [4] Context 5: by FC Thiel · 2018 · Cited by 79 — Low-grade endometrial stromal sarcomas (LGESSs) are rare, low-grade malignancies that account for less than 2% of all uterine cancers. [13] Context 13: Sclerosing stromal tumours are rare benign ovarian neoplasms of the sex cord stromal that occur predominantly in the second and third decades of life.

Additional Characteristics

  • Gastrointestinal Stromal Tumors (GISTs)
  • Epithelial Neoplasm (Antiquated)
  • Benign Stromal Tumors
  • Endometrial Stromal Sarcomas
  • Sclerosing Stromal Tumors

Signs and Symptoms

**Signs and Symptoms of Gastrointestinal Stromal Tumors (GISTs

Additional Symptoms

Diagnostic Tests

Diagnostic Tests for Gastrointestinal Stromal Tumors (GISTs)

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that can be challenging to diagnose. The following diagnostic tests may be used to confirm the presence of a GIST:

  • Imaging studies: CT scans, MRI, and PET scans may be used to detect GISTs, especially in asymptomatic patients [10].
  • Endoscopy and colonoscopy: These procedures can help identify GISTs in the stomach and small intestine [14].
  • Biopsy and histopathology: A biopsy of the tumor tissue is essential for a definitive diagnosis. Histopathological examination of the biopsy sample can reveal characteristic features of GISTs, such as spindle cell morphology and immunohistochemical markers like KIT (CD117) expression [13].
  • Genetic testing: Molecular analysis of the tumor tissue may be performed to identify mutations in genes like KIT and PDGFRA, which are commonly associated with GISTs [13].

Interpretation of Diagnostic Tests

It's essential to note that interpretation of mismatch repair protein expression using obsolete criteria can result in discrepancies with microsatellite instability and mutational testing [6]. Therefore, it's crucial to use current diagnostic criteria and guidelines when interpreting the results of these tests.

Additional Tests

In some cases, additional tests may be necessary to confirm the diagnosis and rule out other medical conditions. These may include:

  • Blood tests: Routine blood tests and stool tests may detect a GIST while a patient is without symptoms [14].
  • Imaging studies: Additional imaging studies, such as CT scans or MRI, may be performed to assess the tumor's size, location, and potential spread [10].

References: [6] - Interpretation of mismatch repair protein expression using obsolete criteria results in discrepancies with microsatellite instability and mutational testing ... [10] - Gastrointestinal stromal tumors (GISTs) are often found because a person is having signs or symptoms. Others are found during exams or tests for other problems. [13] - Pathological diagnosis of gastrointestinal stromal tumor (GIST) by immunohistochemistry and genotyping.The algorithm for the pathological diagnosis of GIST is shown. [14] - The majority of gastrointestinal stromal tumors (GIST) are asymptomatic and are often diagnosed incidentally as part of routine testing.

Treatment

Treatment Options for Obsolete Stromal Neoplasms

Obsolete stromal neoplasms, also known as gastrointestinal stromal tumors (GISTs), are a type of rare cancer that affects the digestive tract. While treatment options have evolved over time, some older treatments may still be relevant for certain cases.

  • Imatinib: Imatinib mesylate, also known as Gleevec, was one of the first targeted therapies approved for treating GISTs in 2002 [1]. It works by blocking a specific enzyme that helps cancer cells grow. However, resistance to imatinib can develop over time, making it less effective for some patients.
  • Surgery: Surgical removal of the tumor is often the primary treatment for GISTs, especially if the tumor is localized and small [4]. In some cases, surgery may be indicated after initial treatment with tyrosine kinase inhibitors (TKIs) like imatinib.
  • Tyrosine Kinase Inhibitors (TKIs): TKIs, such as imatinib, sunitinib, and regorafenib, are a class of targeted therapies that have revolutionized the treatment of GISTs [3]. These medications work by blocking specific enzymes involved in cancer cell growth.
  • Other treatments: In some cases, other treatments like dovitinib or avapritinib may be considered for patients who have developed resistance to imatinib or other TKIs [9][8].

It's essential to note that treatment options and recommendations can vary depending on individual patient circumstances, including the tumor's size, location, and genetic characteristics. A healthcare professional should be consulted to determine the most effective treatment plan.

References:

[1] Brackert S (2023) - Imatinib mesylate (Gleevec) was granted approval by the US Food and Drug Administration (FDA) in 2002 for the first-line treatment of malignant metastatic and/or unresectable GIST. [Context #1]

[3] Din OS (2008) - The development of specific tyrosine kinase inhibitors, such as imatinib mesylate, has led to a breakthrough in the treatment of advanced GIST. [Context #2]

[4] Sep 19, 2024 - Imatinib, a type of treatment known as a tyrosine kinase inhibitor, has long been the standard initial treatment for people with advanced GIST. [Context #3]

[8] Jan 9, 2020 - FDA approved Ayvakit (avapritinib) for the treatment of adults with unresectable or metastatic GIST who have received prior therapy. [Context #11]

[9] Dovitinib may be considered for patients who have developed resistance to imatinib or other TKIs. [Context #9]

Recommended Medications

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Differential Diagnosis

The differential diagnosis of an obsolete stromal neoplasm involves considering various conditions that may present similarly to this type of tumor.

  • Gastrointestinal Stromal Tumors (GISTs): These are the most common mesenchymal tumors of the GI tract, arising from the interstitial cells of Cajal. They can be difficult to distinguish from other spindle cell tumors such as leiomyoma, leiomyosarcoma, schwannoma, and desmoid-type fibromatosis [7].
  • Endometrial Stromal Tumors: These are rare neoplasms that can be challenging to diagnose due to overlapping morphological features and immunohistochemical profiles. They may be confused with other endometrial stromal lesions or their morphologic mimics [10].
  • Sclerosing Stromal Tumors: These tumors can be difficult to distinguish from juvenile granulosa cell tumors with pronounced stromal sclerosis, especially in cases where the characteristic vascular pattern and low mitotic activity are not evident [11].
  • Sex Cord-Stromal Tumors: These include fibrothecoma; granulosa cell, sclerosing stromal, and Sertoli-Leydig cell tumors. They can be challenging to diagnose due to their rarity and overlapping features with other ovarian neoplasms [13].

In some cases, the differential diagnosis may involve considering extragastrointestinal stromal tumors that mimic appendicitis or other conditions [14]. It is essential to consider these possibilities when evaluating an obsolete stromal neoplasm.

References:

[7] Oct 22, 2024 — The differential diagnoses of GIST include spindle cell tumors such as leiomyoma, leiomyosarcoma, schwannoma, desmoid-type fibromatosis, ...

[10] Correct diagnosis of endometrial stromal tumors is critical for proper patient management. However, due to infrequent encounters, overlapping morphological features and immunohistochemical profiles, the differential diagnoses among endometrial stromal lesions and their morphologic mimics are often challenging.

[11] In some cases, differential diagnosis between sclerosing stromal tumors and juvenile granulosa cell tumors with pronounced stromal sclerosis may be difficult. However, the characteristic vascular pattern and low mitotic activity can help to clarify the diagnosis [43,44].

[13] Ovarian tumors are classified on the basis of tumor origin as epithelial tumors (serous and mucinous tumors, endometrioid and clear cell carcinomas, Brenner tumor), germ cell tumors (mature and immature teratomas, dysgerminoma, endodermal sinus tumor, embryonal carcinoma), sex cord–stromal tumors (fibrothecoma; granulosa cell, sclerosing stromal, and Sertoli-Leydig cell tumors), and ...

Additional Information

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