Introducere: Tumorile gastrointestinale stromale (GIST) sunt cele mai frecvente tumori mezenchimale ale tractului gastro-intestinal.
5% din GIST sunt localizate în duoden.
Obiectiv: Analiza frecvenåei, particularitãåilor tabloului clinic, aspectelor histopatologice æi imunohistochimice æi a rezultatelor tratamentului
tumorilor GIST duodenale.
Material æi metode: 6 pacienåi cu GIST (c-kit(CD117)(+) ale duodenului operaåi între 2007–2015.
Rezultate: Vârsta medie – 53.7±2.0ani. Raportul B:F=1:2. Simptomul principal – durerea abdominalã în 3(50%) cazuri, GIST depistat
ocazional – în 3(50%) cazuri. Prezentare iniåialã print-o complicaåie – hemoragie digestivã superiorã în 2(33.3%) cazuri. Localizarea
tumorilor în duoden: în D2 – 3(50%) pacienåi, D3 – 3(50%). Dimensiunea medie a tumorilor GIST duodenale – 7.6±1.9 cm. Tumorile
GIST cu dimensiuni ≤5cm vs. >5cm – 2(33.3%) vs. 4(66.7%) (p<0.05). Caracterul exoluminal de creætere al GIST – 2 (33.3%) vs.
caracter mixt de creætere – 4 (66.7%) (p<0.05). Frecvenåa tumorior GIST cu risc redus (≤5/50 HPF) – 2(33.3%) pacienåi, cu risc înalt
(>5/50 HPF) – 4(66.7%) (p<0.05). Numãrul mediu al mitozelor pentru grupul cu risc redus – 3.5±1.5, pentru grupul cu risc înalt –
10.5±2.9. Volumul operaåiilor: excizia tumorii duodenului – 2(33.3%) cazuri, rezecåia duodenului cu anastomozã – 2(33.3%), rezecåia
pancreatoduodenalã – 2(33.3%). Supravieåuirea generalã în medie – 41.3±10.9 luni. Metastaze la adresarea primarã s-au înregistrat
într-un caz (16.7%). Progresare a fost înregistratã într-un caz (16.7%). Au fost supuæi tratamentului combinat – chirurgical æi terapie
åintitã cu imatinib mesilat – 3(50%) pacienåi.
Concluzii: Tumorile GIST duodenale se pot prezenta printr-o complicaåie (hemoragie digestivã superiorã) sau sunt descoperite
incidental. GIST ale duodenului posedã mai frecvent un risc înalt de progresare sau metastazare. Tratamentul chirurgical rãmâne
metoda principalã de tratament.

Introduction: gastrointestinal stromal tumors (GIST) are the most common mesenchimal tumors of the gastrointestinal tract. 5%
are localized in the duodenum.
Aim: analysis of frequency, clinical presentation, histopathological and immunohistochemical characteristics and treatment results
of duodenal GIST.
Material and methods: 6 patients with c-kit(CD117)(+) GIST of the duodenum treated between 2007–2015.
Results: mean age – 53.7±2.0 years. Male to female ratio – 1:2. Main symptom – abdominal pain in 3 cases (50%), incidental GISTs
– 3(50%). Initial presentation by a complication – upper gastrointestinal bleeding – in 2 cases (33.3%). Localization of tumors in
the duodenum: D2 – 3 cases (50%), D3 – 3(50%). Mean size of duodenal tumors – 7.6±1.9 cm. GIST with size ≤5cm vs. >5cm –
2(33.3%) vs. 4(66.7%) (p<0.05). Exoluminal growth – 2 cases (33.3%) vs. mixt growth – 4 (66.7%) (p<0.05). Frequency of GIST
with low risk (≤5/50 HPF) – 2(33.3%), with high risk (>5/50 HPF) – 4(66.7%) (p<0.05). Mean number of mitosis for the low risk
group – 3.5±1.5, for the high risk group – 10.5±2.9. Surgery: excision of duodenal tumor – in 2 (33.3%) cases, duodenal resection
with anastomosis – 2(33.3%), duodenopancreatectomy – 2(33.3%). Overall survival was 41.3±10.9 months. Metastatic disease at
admission was registered in one case. Progression – in one case (16.7%). Surgery followed by target treatment – in 3 patients
(50%).
Conclusions: duodenal GISTs can present at admission with a complication (upper gastrointestinal bleeding) or are incidental.
Duodenal GISTs have more frequently a high risk of progression and surgical treatment is still the main treatment.