Giant Esophageal GIST: Diagnostic and Therapeutic Challenge - Case Report.

GIST are rare mesenchymal tumors of the digestive tract (less than 1% of the digestive tract neoplasia). Of these, less than 1% are found in the esophagus. Surgery is the main treatment of GIST and is supported by targeted therapy with tyrosine kinase inhibitors like imatinibmesylate. We present the case of a female patient of 51 years, admitted in our clinic for a bulky tumor in the posterior mediastinum, diagnosed after investigations performed for fatigue for the great efforts. Clinical examination was unspecific. Chest X-ray and thoraco-abdominal CT identified a widening of the mediastinum through a posterior mediastinal tumor mass, determining a deviation to the left of the thoracic esophagus without causing not abledysphagia or respiratory symptoms. It was decided surgery by thoracotomy in V right intercostal space and total excision of the tumor was performed. Histopathology examination confirmed the preoperative suspicion of esophageal GIST. Prognosis is reserved, the risk of relapse is very high given the fact that the tumor was extracted fragmented. Currently the patient is under treatment with imatinib mesylate and entered into clinical and imaging follow-up program, according to clinical guidelines.

[Study on the evaluation of complementary imaging methods in rectal neoplasia]. / Studiu asupra evaluarii neoplaziilor rectale prin metode imagistice complementare.

The actual strategies of rectal neoplasia's treatment needs an evaluation closer to the reality of the tumor stadium. Imagistic paraclinical exams must bring data about tumor relation with the rectal wall and the mesorectal fascia, the lymph nodes and other important structures invasion. In this purpose it was used a pelvic magnetic resonance imaging (IRM) and computed tomography (CT) comparatively with surgical findings and pathological results on 15 patients with benign and malignant rectal neoplasia, 6 men and 9 females. We apreciate that computed tomography is the choice for imagistic approach of urinary system, mesorectal nodes and uterus and that IRM is best in imagistic evaluation of anterior subperitoneal structures and mesorectal fascia. In these cases association of the IRM exam with spiral CT provides best results concerning tumoral staging.