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EP447 Clinical and ultrasound features of extra gastrointestinal stromal tumors (eGIST)
  1. D Fischerova1,
  2. M Ambrosio2,
  3. AC Testa3,
  4. F Moro3,
  5. D Franchi4,
  6. MC Scifo2,
  7. N Rams5,
  8. E Epstein6,
  9. JL Alcazar7,
  10. JJ Hidalgo8,
  11. C Van Holsbeke9,
  12. A Burgetova10,
  13. P Dundr11 and
  14. D Cibula1
  1. 1Gynecologic Oncology Centre, Department of Obstetrics and Gynecology, First Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
  2. 2Department of Obstetrics and Gynecology, S. Orsola Malpighi Hospital, University of Bologna, Bologna
  3. 3Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome
  4. 4Division of Gynecology, European Institute of Oncology, Milan, Italy
  5. 5Hospital Santa Cruz y San Pablo, Barcelona, Spain
  6. 6Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden
  7. 7Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, University of Navarra, Pamplona
  8. 8Department of Obstetrics and Gynecology, Clinic Hospital Valencia, Valencia, Spain
  9. 9Ziekenhuis Oost-Limburg, ZOL, Genk, Belgium
  10. 10Department of Radiology
  11. 11Department of Pathology, First Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic


Introduction/Background To describe the clinical and sonographic characteristics of extra-gastrointestinal stromal tumors (eGISTs).

Methodology This is a retrospective multicentric study. From the database of 9 large European gynecologic oncology centers we identified patients with a histological diagnosis of eGIST, who had undergone preoperative ultrasound. One author from each center reviewed stored images and ultrasound reports, and described the lesions using IOTA and MUSA nomenclatures following ultrasound evaluation form. In addition, clinical information, surgical and pathological reports were recorded.

Results Thirty-five women with eGISTs were identified, 17 incidental findings and 18 symptomatic cases. Median age was 57 years (range 21–85). Two patients (6%) had ascites and median CA 125 was 23 U/mL (range 7–403 U/mL). The vast majority of eGISTs were intraperitoneal lesions (33/35, 94%) with few retroperitoneally (2/35, 6%). The most common site was abdomen (23/35, 65.7%), and 12 lesions (34%) were in the pelvis. eGISTs were typically large (median of 79 mm) and solid tumors (31/35, 89%), the remaining eGISTs were multilocular-solid tumors (4/35, 11%). The tumor shape was mainly lobulated (20/35, 57%) or irregular (10/35, 29%). The echogenicity of solid tumors was less often uniform (8/35, 23%) but always hypoechogenic. More frequently solid tumors were non-uniform due to mixed echogenicity (13/27, 40%) or small irregular cysts (14/27, 37%). eGISTs were typically richly vascularized (color score 3 and 4, 31/35, 89%) with no shadowing (31/35, 89%). Based on pattern recognition, eGISTs were usually correctly classified as malignant lesion (32/35, 91%) and the specific diagnosis of eGIST was the most frequent among the presumed diagnosis (16/35, 46%).

Conclusion On ultrasound, eGISTs were usually solid non-uniform intraperitoneal tumors with rich vascularization and no shadowing. They may mimic ovarian fibroma or uterine fibroids but the extra-genital origin in the combination with ultrasound characteristics in experienced hands point to the diagnosis of these uncommon tumors.

Disclosure This work was supported by Charles University in Prague (UNCE 204065 and PROGRES Q28/LF1). None of the authors declare any conflict of interest.

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