Gastrointestinal Stromal Tumor (GIST)
Most prevalent intramural gastric tumor
Arises from interstitial cells Of (EUS layer 4)
Has higher risk of malignancy than leiomyoma (10-30%)
CD117 (c-kit) = POSITIVE
Smooth muscle actin negative,  Vimentin negative, S100 = negative
Prognosis - Rule of 5's:
    > 5 cm OR > 5 mitoses/50 HPF → Intermediate-risk
    > 5 cm AND > 5 mitoses/50 HPF → High-risk Gastric GIST
Treatment:
 • If < 2 cm can consider endoscopic removal, including band ligation
 • If > 2cm — recommend surgical resection
 • Clearly unresectable or > 5 cm AND > 5 mitoses/50 HPF = imatinib

Dr. Shoukat Ali @DrShoukatAli16

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