{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T10:32:43Z","timestamp":1793097163866,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,10,11]],"date-time":"2020-10-11T00:00:00Z","timestamp":1602374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,10,11]],"date-time":"2020-10-11T00:00:00Z","timestamp":1602374400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the clinical and sonographic characteristics of extragastrointestinal stromal tumors (eGISTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a retrospective multicenter study. The data of patients with a histological diagnosis of eGIST who had undergone preoperative ultrasound examination were retrieved from the databases of nine large European gynecologic oncology centers. One investigator from each center reviewed stored images and ultrasound reports, and described the lesions using the terminology of the International Ovarian Tumor Analysis and Morphological Uterus Sonographic Assessment groups, following a predefined ultrasound evaluation form. Clinical, surgical and pathological information was also recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010five women with an eGIST were identified; in 17 cases, the findings were incidental, and 18 cases were symptomatic. Median age was 57\u2009years (range, 21\u201385\u2009years). Tumor marker CA\u2009125 was available in 23 (65.7%) patients, with a median level of 23\u2009U\/mL (range, 7\u2013403\u2009U\/mL). The vast majority of eGISTs were intraperitoneal lesions (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932 (91.4%)); the remaining lesions were retroperitoneal (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092 (5.7%)) or preperitoneal (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091 (2.9%)). The most common site of the tumor was the abdomen (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923 (65.7%)), and less frequently the pelvis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912 (34.3%)). eGISTs were typically large (median largest diameter, 79\u2009mm) solid (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200931 (88.6%)) tumors, and were less frequently multilocular\u2010solid tumors (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094 (11.4%)). The echogenicity of solid tumors was uniform in 8\/31 (25.8%) cases, which were all hypoechogenic. Twenty\u2010three solid eGISTs were non\u2010uniform, either with mixed echogenicity (9\/23 (39.1%)) or with cystic areas (14\/23 (60.9%)). The tumor shape was mainly lobular (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919 (54.3%)) or irregular (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910 (28.6%)). Tumors were typically richly vascularized (color score of 3 or 4,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200931 (88.6%)) with no shadowing (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200931 (88.6%)). Based on pattern recognition, eGISTs were usually correctly classified as a malignant lesion in the ultrasound reports (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932 (91.4%)), and the specific diagnosis of eGIST was the most frequent differential diagnosis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916 (45.7%)), followed by primary ovarian cancer (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095 (14.3%)), lymphoma (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092 (5.7%)) and pedunculated uterine fibroid (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092 (5.7%)).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>On ultrasound, eGISTs were usually solid, non\u2010uniform pelvic or abdominal lobular tumors of mixed echogenicity, with or without cystic areas, with rich vascularization and no shadowing. The presence of a tumor with these features, without connection to the bowel wall, and not originating from the uterus or adnexa, is highly suspicious for eGIST. Copyright \u00a9 2020 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/uog.21968","type":"journal-article","created":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T06:17:58Z","timestamp":1578377878000},"page":"749-758","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Imaging in gynecological disease (19): clinical and ultrasound features of extragastrointestinal stromal tumors (\n                    <scp>eGIST<\/scp>\n                    )"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6188-3458","authenticated-orcid":false,"given":"M.","family":"Ambrosio","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology S. Orsola Malpighi Hospital, University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2217-8726","authenticated-orcid":false,"given":"A. C.","family":"Testa","sequence":"additional","affiliation":[{"name":"Dipartimento Scienze della Salute della Donna e del Bambino Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"},{"name":"Dipartimento Scienze della Vita e Sanit\u00e0 pubblica Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5070-7245","authenticated-orcid":false,"given":"F.","family":"Moro","sequence":"additional","affiliation":[{"name":"Dipartimento Scienze della Salute della Donna e del Bambino Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3950-5538","authenticated-orcid":false,"given":"D.","family":"Franchi","sequence":"additional","affiliation":[{"name":"Division of Gynecology European Institute of Oncology  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. C.","family":"Scifo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology S. Orsola Malpighi Hospital, University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Rams","sequence":"additional","affiliation":[{"name":"Hospital Santa Cruz y San Pablo  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2298-7785","authenticated-orcid":false,"given":"E.","family":"Epstein","sequence":"additional","affiliation":[{"name":"Department of Clinical Science and Education Karolinska Institutet &amp; Department of Obstetrics and Gynecology, S\u00f6dersjukhuset  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9700-0853","authenticated-orcid":false,"given":"J. L.","family":"Alcazar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Clinica Universidad de Navarra, University of Navarra  Pamplona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1995-6435","authenticated-orcid":false,"given":"J. J.","family":"Hidalgo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Clinic Hospital Valencia  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Van Holsbeke","sequence":"additional","affiliation":[{"name":"Ziekenhuis Oost\u2010Limburg, ZOL  Genk Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9975-2338","authenticated-orcid":false,"given":"A.","family":"Burgetova","sequence":"additional","affiliation":[{"name":"Department of Radiology, First Faculty of Medicine Charles University and General University Hospital in Prague  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8940-6124","authenticated-orcid":false,"given":"P.","family":"Dundr","sequence":"additional","affiliation":[{"name":"Department of Pathology, First Faculty of Medicine Charles University and General University Hospital in Prague  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6387-9356","authenticated-orcid":false,"given":"D.","family":"Cibula","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, First Faculty of Medicine Charles University and General University Hospital in Prague  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7224-3218","authenticated-orcid":false,"given":"D.","family":"Fischerova","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, First Faculty of Medicine Charles University and General University Hospital in Prague  Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-005-0005-5"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3880099"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2005.40709.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i6.1845"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199909000-00015"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.5858\/2000-124-1471-COOGST"},{"key":"e_1_2_7_8_1","first-page":"1038","article-title":"Smooth muscles and stem cells of embryonic guts express KIT, PDGFRRA, CD34 and many other stem cell antigens: suggestion that GIST arise from smooth muscles and gut stem cells","volume":"6","author":"Terada T","year":"2013","journal-title":"Int J Clin Exp Pathol"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200404000-00007"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1009199108"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000807"},{"key":"e_1_2_7_12_1","volume-title":"TNM Classification of Malignant Tumours","author":"Brierley JD","year":"2017"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1469-0705.2000.00287.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.14806"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.5251"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gore.2018.04.006"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1438.2007.01121.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3892\/or_00000301"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4097"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.907654"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2009.28.7.941"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-005-0308-6"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.6394"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdl274"},{"key":"e_1_2_7_25_1","first-page":"1293","article-title":"Biological and clinical review of stromal tumors in the gastrointestinal tract","volume":"15","author":"Nishida T","year":"2000","journal-title":"Histol Histopathol"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(05)70394-7"}],"container-title":["Ultrasound in Obstetrics &amp; 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