A 45-year-old woman undergoes endoscopy for dyspepsia and is found to have a 4 cm submucosal tumor in the gastric body. Endoscopic ultrasound confirms it arises from the muscularis propria. CT shows no metastasis. Biopsy confirms a gastrointestinal stromal tumor (GIST) with low mitotic index. What is the recommended surgical approach?
- A Wedge resection with negative margins ✓
- B Total gastrectomy with D2 lymphadenectomy
- C Neoadjuvant imatinib followed by surgery
- D Endoscopic submucosal dissection
Correct answer: A. Wedge resection with negative margins
Explanation
Gastric GISTs are treated with wedge resection achieving negative margins. Lymphadenectomy is unnecessary because nodal metastasis is rare in GIST. Neoadjuvant imatinib is reserved for large or poorly located tumors to enable organ-sparing surgery, or for metastatic disease. ESD is inappropriate for submucosal tumors arising from muscularis propria.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.