Internal Medicine

0521779407-08 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:47

608 Gastric Stromal Tumor Gastroenteritis

■indolent

■bleeding, pain, obstruction or palpable mass in advanced tumor

■Carney’s triad: leiomyosarcoma, pulmonary chondroma, and func-

tioning extra-adrenal paraganglioma

tests

■CBC: anemia. LFT: liver metastasis is common.

■endoscopy: subepithelial lesion with normal overlying mucosa with

or without central umbilication or ulceration. Biopsy of mucosa is

usually normal

■endoscopic ultrasonography to confirm diagnosis and to assess like-

lihood of malignancy (large lesion, mostly extraluminal with irregu-

lar border, regional lymph node involvement).

differential diagnosis

■lipoma, pancreatic rest, carcinoid, neuroma, extrinsic compression

management

■endoscopic ultrasound to confirm diagnosis.

■CXR, CT scan

■Tests

■surgery for suspected malignant lesions

■serial ultrasound may be a useful medium to follow progression

specific therapy

n/a

follow-up

■no specific guidelines.

complications and prognosis

■if malignant, 5-year survival with curative surgery: 60%. In incom-

plete

■resection: 25%

Gastroenteritis......................................

SUZANNE M. MATSUI, MD and JAYSHREE MATADIAL, MD

history & physical

History

■travel: foreign, or to mountainous regions

➣also consider exposure to contaminated water