leiomyoma/gist cytology results

A routine colonoscopy found a medium size lesion pressing into the colon at 15cm from the anal verge.  The Dr. thought it might be a lipoma.

I was referred for an endoscopic ultrasound thru the colon and after the procedure the Dr. indicated the lesion was a 1.7cm leiomyoma or GIST.   (Lesion was hypoechoic and in the muscularis propria, indicative of gists).  He indicated that the cytology results will probably be inconclusive so I should consider surgery to remove the lesion just to be safe.  I have since learned that gists can become cancerous.  My grandfather had a rare muscle sarcoma, and since a gist is a muscle sarcoma in the GI tract, it seems prudent to remove just to be sure.  I also learned that small gists can be difficult to diagnose.

The cytology report sent to my gastroenterologist and said "reactive glandular epithelial cells and adipose tissue noted" and was sent to my gastroenterologist.

I received a call from my gastroenterologis that since the lesion is benign to come back in 10 YEARS for another colonoscopy.

I am confused since Dr. doing ultrasound recommended surgery but my gastoenerologist says do nothing.

Would you recommend I get another opinion regarding surgical removal to ensure the lesion is not a GIST?  Or do the cytology results indicate this is not a problem ?

[Kevin Pho, MD]

I would get another opinion in the face of conflicting recommendations.  

The cytology should give a definitive opinion.  However, a biopsy would be more conclusive - and should be considered.  If the biopsy continues show benign findings, then the recommendation for periodic screening is reasonable.  

However, a referral to a surgeon can be considered - preferably at a major academic medical center.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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