Resumo
Definition
History and exam
Key diagnostic factors
- massa
- hemorragia digestiva alta/baixa
- dor neuropática
- aumento da circunferência abdominal
- características de abdome agudo
Other diagnostic factors
- edema de membros unilateral
- perda de peso
- fadiga
- anorexia
- distensão abdominal, desconforto e dor
Risk factors
- síndromes geneticamente hereditárias
- radiação
- infecção por herpes-vírus humano tipo 8 (HHV-8)
- doenças congênitas
- sexo masculino
- linfedema
- história de exposição a carcinógenos químicos
Diagnostic investigations
1st investigations to order
- tomografia computadorizada (TC) do tumor primário
- ressonância nuclear magnética (RNM) do tumor primário
- TC do tórax
- biópsia para histologia
Investigations to consider
- tomografia computadorizada abdominal/pélvica
- ressonância nuclear magnética (RNM) da coluna vertebral total
- tomografia por emissão de pósitrons com fluordesoxiglucose/tomografia computadorizada (FDG-PET-CT)
- endoscopia
- hemograma completo
- exames de coagulação
- ureia
- creatinina
- testes da função hepática
- ecocardiograma ou angiografia sincronizada multinuclear (MUGA)
- técnicas auxiliares
Treatment algorithm
membro: estádio I
membro: estádio II, ressecável
membro: estádio III ou estádio IV selecionado (qualquer T, N1, M0), ressecável
membro: estádio III ou estádio IV selecionado (qualquer T, N1, M0), irressecável
membro: estádio IV, oligometástases com volume tumoral limitado ou linfonodos regionais
membro: estádio IV, metástases disseminadas
membro: recorrente
retroperitoneal/intra-abdominal: ressecável (primário ou recorrente)
retroperitoneal/intra-abdominal: irressecável
retroperitoneal/intra-abdominal: doença metastática, órgão único e volume tumoral limitado passível de terapia local
retroperitoneal/intra-abdominal: metástases disseminadas
tumor estromal gastrointestinal: ressecável com morbidade mínima
tumor estromal gastrointestinal: ressecável com morbidade significativa
tumor estromal gastrointestinal: irressecável
tumor estromal gastrointestinal: progressivo
tumor estromal gastrointestinal: recorrente ou metastático
Contributors
Authors
James S. Hu, MD, FACP
Associate Professor of Clinical Medicine
USC Norris Comprehensive Cancer Center
Los Angeles
CA
Disclosures
JSH declares that he has no competing interests.
Sant P. Chawla, MD, FRACP
Director
Sarcoma Oncology Center
Santa Monica
CA
Disclosures
SPC owns stock in AADi, Cellestia Biotech, CounterPoint, and Immix BioPharma, and has received grants, consulting fees, payments of honoraria, and payment from speakers bureau for Amgen, Roche, GSK, Threshold Pharmaceuticals, CytRx Corporation, Ignyta, Immune Design, TRACON Pharma, Karyopharm Therapeutics, Sarcoma Alliance for Research through Collaboration (SARC), Janssen, Advenchen Laboratories, Bayer, Inhibrx, NKMax, and Thyme.
Acknowledgements
Dr James S. Hu and Dr Sant P. Chawla would like to gratefully acknowledge Dr Swati Sikaria, Dr Jonathan C. Trent, Dr Saira Hassan, and Dr David Thomas, previous contributors to this topic.
Disclosures
SS, JCT and SH each declare that they have no competing interests. DT has received research support from Pfizer, Amgen, and Novartis.
Peer reviewers
Richard F. Riedel, MD
Professor of Medicine
Duke University
Durham
NC
Disclosures
RFR owns shares in Limbguard, has received institutional clinical research support from AADi, Adaptimmune, AROG, Ayala, BioAtla, Blueprint, Cogent, Daiichi-Sankyo, Deciphera, GlaxoSmithKline, InhibRx, NanoCarrier, Oncternal, PTC Therapeutics, SARC, SpringWorks, Tracon, and Trillium. He has been a consultant/advisor for AADi, Adaptimmune, Bayer, Blueprint, Boehringer Ingelheim, Daiichi-Sankyo, Deciphera, GlaxoSmithKline, NanoCarrier, SpringWorks and has received funding for travel from Deciphera.
Differentials
- Lipoma
- Úlcera gastrointestinal
- Linfoma
More DifferentialsGuidelines
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More Guidelines
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