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NCCN Guidelines for Patients


Soft Tissue Sarcoma, Version 1.2014



Gastrointestinal stromal tumors Treatment planning

surgery but might need other types of treatment. It’s

important to confirm that the tumor is cancer before

starting treatment.

For EUS-FNA, an endoscope will be guided down

your esophagus to the tumor. An endoscope is a

device with a thin, long tube. At the end of the tube

is a light and camera that allows your doctor to see

into your body. Endoscopes used for EUS-FNA are

fitted with ultrasound, which is a type of imaging test.

Ultrasound uses high-frequency sound waves to

make pictures. Your doctor will move the ultrasound

back and forth to see a 360-degree view of the area

on a screen. Once the endoscope is within reach of

the tumor, a needle will be used to obtain a sample.

You will likely be sedated for EUS-FNA but sometimes

anesthesia is used.

If after the first biopsy it is unclear if the tumor is

cancer, a second biopsy should be done. If the tumor

is cancer, more testing should be done to learn more

about the cancer. Your doctors will want to know the

cancer grade. Testing for abnormal genes within the

cancer cells may also be done. It is important that the

testing be done by a pathologist who has experience

with sarcoma.

Imaging of abdomen and pelvis

If you likely have GIST, you should receive a CT scan

of your abdomen and pelvis. CT is a type of imaging

test. It takes many x-rays of the same body part from

different angles to make detailed images. Your doctor

may have you have another imaging test called MRI.

MRI uses radio waves and powerful magnets to make

images. Imaging can show your doctors how large a

tumor is and how close it is to other tissues.

A contrast dye should be used to make the images

clearer. The dye will be injected into your vein, mixed

with a liquid you drink, or both. The dye may cause

you to feel flushed or get hives. Rarely, serious

allergic reactions occur. Tell your doctor and the

technicians if you have had bad reactions in the past.

Getting an imaging scan is often easy. Before the

scan, you may need to stop taking some medicines,

stop eating and drinking for a few hours, and remove

metal objects from your body. During the scan, you

will need to lie face up on a table that moves through

the machine. As the machine takes pictures, you may

hear buzzing, clicking, or whirring sounds. You will be

alone, but a technician will operate the machine in a

nearby room. He or she will be able to see, hear, and

speak with you at all times. You will likely be able to

resume your activities right away unless you took a


KIT and PDFGRA testing

Many (85 out of 100) GISTs have mutations in



gene. KIT is a molecule within a chemical

pathway that starts cell growth. It is sometimes called

CD117. The mutations in the


gene cause KIT