GastroIntestinal Stromal Tumor (GIST)

A male aged 64 years Chief Complaints Pain Rt HUQ (x 2 months) Loss of Weight Loss of Appetite Weakness Physical Examination Hepatomegaly, Irregular surface, BS (+) Investigations USG s/o Multiple Liver SOL's with a hypoechoic mass abutting jejunal loops approx 5 cm USG guided biopsy done from Liver SOL... Reports given... Management What would be further line kf management

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Firstly we would want to know if it is a GIST or a leiomyosarcoma Hence Immunohistochemistry (IHC) is necessary to know the type of disease If GIST then ina metastatic disease starting Imatinib or apavritinib would be ideal.....and if regression or stable disease can continue Imatinib If leiomyosarcoma : a cytotoxic chemotherapy regimen can be started

Liver sol biopsy hp Malignancy Jejunal loop Gist Enteroscopic biopsy hp Maybe metastatic or main lesion Secondary in liver

Gasterointestinal tumor DX on HPE is Leomyosarcoma DoG 1 FDG shows multiple lesions in liver uptake suggest metastasis So it is a c/o malignant abdomen MX depends on further workout My suggestion is chemotherapy/radiation

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