Abstract

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Title:: Misdiagnosis factors and differential diagnosis of gastrointestinal stromal tumors

Author(s):: WU Yu; CHEN Jiali; LIU Xiaowen; BU Jun; Department of Radiology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou 510220, China

Keywords:: ; gastrointestinal tract; stromal tumors; imaging diagnosis; differential diagnosis

Abstract:: Objective To analyze factors causing misdiagnosis of gastrointestinal stromal tumors (GIST) and provide some key points for the differential diagnosis of GIST. Methods The imaging data of 11 patients who were misdiagnosed as GIST and 2 patients with GIST who were misdiagnosed before operation in Guangzhou Red Cross Hospital from April 2014 to May 2017 were retrospectively analyzed. All 13 cases were confirmed by operation and pathology and underwent MSCT scanning. We observed the features of CT imaging, analyzed the imaging factors affecting the diagnosis of GIST and evaluated their values in differential diagnosis. Results The pathological diagnosis results of 13 patients who were all misdiagnosed included retroperitoneal schwannoma (2/13), poorly differentiated adenocarcinoma (2/13), ectopic pancreas (2/13), gastrointestinal carcinoid (1/13), leiomyoma (1/13), undifferentiated sarcoma (1/13), metastatic carcinoma (2/13) and small intestinal stromal tumor (2/13). Misdiagnosis was related to tumor location, size, source of blood supply, growth trend, observation method and so on. Conclusion GIST has some certain imaging features. To reduce misdiagnosis rate, accurate localization of mass in three-dimensional reconstruction is the priority among priorities; the observation of subtle but key signs about mass are also important; and the source of blood supply and growth trend of mass should also be considered in the differential diagnosis of GIST.