stomach

GIST Stomach

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Q ) Antral GIST 1cm incidentally found on UGIE. True regarding its management

a) Surgical resection resection of GIST (More questions on GIST here) 

b) Endoscopic resection

c) Resection required if EUS suggests irregular border with cystic spaces

d) Endoscopic surveillance, if size >2cm then resect

Answer ( You need to be a premium member to see this) 

GIST are usually found in the stomach (40% to 60%), small intestine (30%), and colon (15%). Clinically they appear  in patients older than 50 years.

They generally have an equal male-to-female ratio or a slight male predominance.

They are rarely associated with familial syndromes such as GISTparaganglioma syndrome (Carney triad), neurofibromatosis 1, and von Hippel-Lindau disease, but most develop de novo. 

Gastric Lymphoma

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Q) Gastric Lymphomas false is 

a) The optimal treatment for lymphomas unresponsive to initial H. pylori antibiotic treatment remains unclear and includes the chemotherapy, radiotherapy, surgical resection, etc

b) Almost all MALT-lymphoma may regress with conventional H. pylori treatment. 

c) Need for surgery in lymphoma is mainly for its complication

d) Risk of perforation is over estimated in the literature

Answer

GIST stomach

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Q) Antral GIST 1cm incidentally found on UGIE. True regarding its management
a) Surgical resection 
b) Endoscopic resection
c) Resection required if  EUS suggests irregular border with cystic spaces
d) Endoscopic surveillance, if size >2cm then resect

 

Ans 

c

GIST more than 2 cm should undergo resection. Management of GIST less than 2 cm  is dependent on weather high risk features are present on EUS. 

The high risk features are 

1. Irrgeular margins

2. Heterogenous architecture

3. Ulcers

Management of low risk GIST less than 2 cm is  surveillance every 6 months

 

 

 

CDH 1 mutation

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Q ) Hereditary diffuse Gastric carcinoma is associated with which  breast cancer
A. Ductal carcinoma NOS subtype
B. Lobular carcinoma
C. DCIS
D. Metaplastic carcinoma

Answer for Q 79

Majority of Gastric Cancers are sporadic,

1–3% of GCs arise as a result of inherited cancer predisposition syndromes.

 Li-Fraumeni syndrome, Lynch syndrome, Peutz-Jeghers syndrome, hereditary breast and ovarian cancer,MUTYH-associated adenomatous polyposis (MAP), familial adenomatous polyposis,  juvenile polyposis syndrome and PTENhamartoma tumour syndrome (Cowden syndrome).

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