Small Hypermitotic Gastrointestinal Stromal Tumors

The origin and pathogenesis of GIST has been basically clarified. However, the high recurrence and metastasis rates of GIST still present difficulties for clinicians. Most GIST classification criteria are based on tumor size, mitotic count, and tumor location, but these criteria cannot accurately predict the recurrence of GIST. It is widely believed that the size of the primary tumor and mitotic image are important indicators to judge the degree of malignancy and determine the operation method, in which mitotic image should be more heavily weighted. Clinically, during the diagnosis and treatment of GIST, it is not uncommon to find that the tumor volume is small, but the number of mitotic images is high. The Union Hospital, Tongji Medical College of Huazhong University of Science and Technology conducted a single center investigation of this kind of patient. Among 269 cases of GIST, with a maximum tumor diameter < 2 cm, 14 cases (about 5%) were accompanied by a high mitotic count. The diagnosis and treatment of such patients should pay more attention to genetic testing and adjuvant therapy, and comprehensive evaluation should be conducted.