Stomach GIST


  • A 50 years old lady
  • No previous medical illness
  • Presented with early satiety and progressive abdominal distension. No obstructive or constitutional symptoms.
Scanogram image before the CT scan
CT scan abdomen, pre contrast in axial plane soft tissue window
CT scan abdomen post contrast, axial plane, soft tissue window

CT scan findings:

  • scanogram shows displacement of bowel loops inferiorly (yellow arrows)
  • CT scan shows a huge mass arising from posterior wall of stomach
  • It shows heterogenous enhancement with areas of central necrosis
  • No calcification is seen within the mass lesion.
  • Compression and displacement of surrounding structures are seen, however clear fat plane is still preserved.
  • No contrast extravasation to suggest active hemorrhage.
  • No dilatation of bowel loops. No enlarged nodes

Diagnosis: Stomach GIST (HPE proven)


  • Gastointestinal stromal tumours (GIST) are the most common mesenchymal tumors of the gastrointestinal tract.
  • GIST accounts for about 5% of all sarcomas.
  • Stomach is the commonest location for this tumour (about 70% of cases).
  • Usually occur after 40 years of age, most seen in older patients
  • In this case it bulges extramural not causing any bowel obstruction
  • Imaging appearances vary with size and location.
  • Typically the mass is of soft tissue density with central areas of necrosis.
  • The tumors are often exophytic, Enhancement is typically peripheral (due to central necrosis)
  • Calcification is uncommon (3%)
  • Lymph node enlargement is not a feature
  • Metastases (distant, peritoneal, omental) or direct invasion into adjacent organs may be seen in more aggressive lesions
Author: radhianahassan