Pleomorphic Implications in Gastrointestinal Stromal Tumors

Minimally invasive partial gastrectomies for incidentally identified gastrointestinal stromal tumors (GISTs) are increasingly more common, and most patients have an uneventful perioperative course. The surgical resection is not technically demanding, especially when a wedge resection is performed. Although the majority of relatively small- or intermediate-sized GISTs have low mitotic rates, postoperative surveillance intervals should be shorter for GISTs with higher mitotic rates. Although pleomorphism has not dictated metastatic potential, the addition of dedifferentiation may alter postoperative management. This perspective article details a patient with a pleomorphic gastric GIST that was successfully resected via a wedge resection. The pleomorphic lesion did not show dedifferentiation, so a longer surveillance interval was instituted. This case reaffirms that surgeons should actively review their patients' pathology results in conjunction with oncology, as subtle findings may alter patient surveillance.