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Gastrointestinal stromal tumors are rare neoplasms arising from mesenchymal precursor cells of the gastrointestinal tract
that may differentiate towards the interstitial cells of Cajal, pacemaker cells regulating autonomous motility of G.I. tract.
Grading of GIST has been proven to be as difficult as their classification.
Two thirds of GISTs are located in the stomach, 20-50% in the small bowel (one third in the duodenum), and 5-
15% in colon and rectum; GISTs, however, may rarely be found also in the oesophagus, omentum, mesentery or the
retroperitoneum. The distribuition of these tumors in the stomach is: pars media, 40%; antrum, 25%; pylorus, 20%; in less than 15%,
GISTs location is next to the EGJ, in the cardia and in the fundus.
The upper gastric third location of GISTs is not common, so their surgical management has been not yet well investigated.
Total gastrectomy is considered the therapy of choice for the GIST located next to the EGJ, but wedge resection
could be considered a surgical option in selected cases.
The Authors describe 2 cases of GIST located just under the upper portion of the stomach and discuss about the different
surgical options for GISTs of this region.