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Title: Gastrointestinal stromal tumours - rare disease in children or unrecognizable?

Sabina Więcek, Wojciech Madziara, Urszula Grzybowska-Chlebowczyk, Halina Woś, Janusz Bohosiewicz
Contemporary Pediatrics, Gastroenterology, Hepatology and Child Feeding
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gastrointestinal stromal tumours, children

Gastrointestinal stromal tumours has so far been diseases very rarely diagnosed in children. We present a case report of two children who were admitted to Department of Paediatrics of Medical University of Silesia. We diagnosed gastrointestinal stromal tumours in these children. Clinical symptoms, the course of disease and the prognosis in these children are different. First patient - 15 year-old girl was admitted to hospital due to nausea, abdominal pain localized in the epigastrium and periodical vomiting. In the endoscopy of the upper part of the alimentary tract we found the submucosal tumour of the stomach, with diameter about 15 mm, localized in the subcardial region. The girl was operated, now for five years she has been observed in the outpatient clinic, she expresses no complains, and the control endoscopy of the upper part of the alimentary tract does no show any abnormalities. Gastrointestinal stromal tumour with low mitotic index was diagnosed on the basis of the histopathological examination. The other patient was admitted to Department of Surgery with suspicion of the tumor of the stomach with accompanying intensive hae-morrhage from the upper part of the alimentary tract, with considerable anaemia. In the endoscopy of the upper part of the alimentary tract we found two tumours of the stomach, with diameter about 3 cm each, one with the ulceration and symptoms of active haemorrhage. The surgical operation was done in the urgent procedure. The gastrointestinal stromal tumour was diagnose on the basis of histopathological examination. We are considering treatment with imatinib in this child with regard of the high mitotic index in the histopathological examination and the progression of the disease. In present the description of these cases we would like to draw attention to stromal tumours of the alimentary tract - rare diseases, especially in children.