Stromal tumor

Stromal Tumor

A stromal tumor is a type of neoplasm that arises from the connective tissue, or stroma, of an organ. These tumors can occur in various parts of the body and are often classified based on their location and histological characteristics. Stromal tumors can be benign or malignant, with the latter often referred to as sarcomas.

Classification

Stromal tumors are classified based on their tissue of origin and histological features. Some common types include:

• Gastrointestinal stromal tumor (GIST): These are the most common mesenchymal tumors of the gastrointestinal tract, often found in the stomach or small intestine. They originate from the interstitial cells of Cajal or precursor cells.
• Endometrial stromal sarcoma: A rare form of uterine cancer that arises from the connective tissue of the endometrium.
• Ovarian stromal tumor: These tumors arise from the stromal tissue of the ovary and include types such as granulosa cell tumors and thecomas.

Pathophysiology

Stromal tumors develop from the supportive tissue of an organ, which includes connective tissues, blood vessels, and lymphatics. The pathogenesis often involves genetic mutations that lead to uncontrolled cell proliferation. For example, mutations in the KIT or PDGFRA genes are commonly associated with gastrointestinal stromal tumors.

Diagnosis

The diagnosis of stromal tumors typically involves a combination of imaging studies, histopathological examination, and molecular testing. Common diagnostic procedures include:

• Imaging: CT scans, MRI, and PET scans are used to visualize the tumor and assess its extent.
• Biopsy: A tissue sample is obtained for histological examination to determine the tumor type and grade.
• Immunohistochemistry: This technique is used to detect specific markers that are characteristic of stromal tumors, such as CD117 (c-KIT) in GISTs.

Treatment

The treatment of stromal tumors depends on the type, location, and stage of the tumor. Common treatment modalities include:

• Surgery: Surgical resection is often the primary treatment for localized stromal tumors.
• Targeted therapy: Drugs such as imatinib (Gleevec) are used to target specific mutations in GISTs.
• Radiation therapy: This may be used in certain cases to control tumor growth or alleviate symptoms.
• Chemotherapy: Although less effective for some stromal tumors, it may be used in combination with other treatments.

Prognosis

The prognosis for patients with stromal tumors varies widely depending on factors such as tumor type, size, location, and response to treatment. Early detection and targeted therapies have improved outcomes for many patients.

Also see

• Sarcoma
• Mesenchymal tumor
• Connective tissue
• Oncology

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