Flexible Matching for Noisy Structural Descriptions

Abstract

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, thought to derive from neoplastic outgrowth of the interstitial cells of Cajal. Building on recent advances in recognition, classification and diagnosis, the past two decades have seen a changing paradigm with molecular diagnostics and targeted therapies. <i>KIT</i> and <i>PDGFRA</i> mutations account for 85-90% of GIST carcinogenesis. However, the remaining 10-15% of GISTs, which until recently were called <i>KIT/PDGFRA</i> wild-type GISTs, have been found to have one of the several mutations, including in the <i>SDHA</i>, <i>B</i>, <i>C</i>, <i>D</i>, <i>BRAF</i> and <i>NF1</i> genes. Though most of such GISTs are sporadic, a number of families with high incidence rates of GISTs and other associated clinical manifestations have been reported and found to harbor germline mutations in <i>KIT</i>, <i>PDGFRA</i>, <i>SDH</i> subunits and <i>NF1</i> The goal of this review is to describe the mutations, clinical manifestations and therapeutic implications of syndromic and inherited GISTs in light of recent studies of their clinicopathologic range and pathogenesis.