General CT Features

General features of GISTs depend on the organ of origin and tumor size. Most tumors arise from the muscularis propria of the stomach or small intestine, and the submucosal origin of these tumors explains their typical CT features. They commonly manifest as a dominant exophytic mass. Less common CT findings include dominant intramural and intraluminal masses. Small tumors are typically homogeneous, well defined, and sharply marginated. Contrast enhancement is usually moderate. Large tumors tend to have central necrosis and mucosal ulceration. Enhancement of large tumors is typically heterogeneous, although this feature cannot reliably predict tumor behavior or malignant potential.27 Peripheral contrast enhancement indicates viable tumor, whereas central areas of low attenuation may appear due to hemorrhage, necrosis, or cystic degeneration. Cavitary lesions may develop, which often communicate with the bowel lumen. They may contain air, air-fluid level, or food residue. Calcification is unusual and may be mottled or extensive. Ascites has rarely been reported in patients with GISTs, suggesting that these tumors do not incite local inflammatory reaction. Vessels are often stretched over large tumors, but vascular encasement of the mesenteric and retroperitoneal vessels is

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