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Primary familial GIST syndrome is a rare inherited condition that increases a person’s risk of developing gastrointestinal stromal tumors (GISTs).
A GIST (gastrointestinal stromal tumor) is an uncommon type of cancer that starts in specialized cells in the gastrointestinal (GI) tract. Most GISTs start in the lining of the stomach or small intestine, but they can appear anywhere from the esophagus to the anus.
Most people with GISTs do not have primary familial GIST syndrome. These tumors tend to develop in people who are older than 50 years of age.
People with primary familial GIST syndrome tend to develop GISTs at a younger age. They are also more likely to have more than one GIST.
People with primary familial GIST syndrome might also have other health issues, depending on which gene change is causing the syndrome (see “What are the symptoms of primary familial GIST syndrome?” below).
Primary familial GIST is rare. There are an estimated 50 to 100 known families across the world with this diagnosis.
Primary familial GIST syndrome is passed down in families through an inherited gene change (mutation). Most often, this syndrome is caused by changes in 1 of 2 genes:
Most often, this syndrome is caused by an abnormal KIT gene that is passed from parent to child. This is the same gene that is mutated (changed) in most sporadic (non-inherited) GISTs. (See What Causes Gastrointestinal Stromal Tumors?) People who inherited this abnormal gene from a parent have it in all their cells, while people with sporadic GISTs only have it in the cancer cells.
Less often, an inherited change in the PDGFRA gene causes this syndrome. (Defects in the PDGFRA gene are also found in a small percentage of sporadic GISTs.)
Researchers continue to look for specific genes that may be related to the development of familial GIST and which may be used to help decide the patient’s treatment plan.
Options exist for people who carry a KIT or PDGFRA gene mutation and might want to have children. For more information, talk with an assisted reproduction specialist at a fertility clinic.
People with primary familial GIST syndrome tend to develop GISTs before age 50. They are also more likely to have more than one GIST.
GISTs can cause symptoms such as:
Some GISTs might spread to other parts of the body, such as the liver, omentum (fat tissue in the abdominal cavity), or peritoneum (membrane lining the abdominal cavity), where they might cause other symptoms.
People with primary familial GIST syndrome might also have other health issues, depending on which gene change is causing the syndrome.
When this syndrome is caused by a change (mutation) in the KIT gene, other issues can include:
When this syndrome is caused by a change in the PDGFRA gene, other issues can include:
The diagnosis of a GIST is sometimes based on a biopsy, in which a small piece of the tumor is removed and looked at under a microscope. The type of biopsy done will depend on the tumor’s location. It might be done with a hollow needle, using an endoscopy procedure (such as upper endoscopy or colonoscopy), or during surgery.
Not everyone who has a tumor that might be a GIST needs a biopsy. If the doctor suspects a tumor is a GIST, a biopsy is usually done only if it will help determine treatment options. GISTs are often fragile tumors that tend to break apart and bleed easily. Any biopsy must be done very carefully, because of the risk that the biopsy might cause bleeding or possibly increase the risk of cancer spreading.
If you (or a family member) are diagnosed with a GIST, primary familial GIST syndrome might be considered if:
To diagnose primary familial GIST syndrome, a person must have an inherited (germline) mutation in either the KIT or PDGFRA gene. This can be determined with genetic testing of a sample of a person’s saliva or blood. A doctor or genetic counselor can review your personal and family health history to help determine if you should consider this type of testing.
It is important to note that genetic testing for primary familial GIST syndrome is still evolving. There may be other genes that cause the syndrome, and current tests may not identify all families who have mutations in those specific genes.
People with familial GIST syndrome have an increased risk of developing one or more GISTs. Having a mutation in the KIT gene is linked with a particularly high risk of developing one or more GISTs during a person’s lifetime. However, not everyone with a known mutation will develop a GIST.
It is not known if people with primary familial GIST syndrome have an increased risk of other types of cancer.
Currently, there is no standard screening schedule for people who have a known genetic mutation but who have not developed a GIST. Your doctor will work with you to determine a personal screening plan that is best for you.
In general, different types of imaging tests such as CT or MRI scans, or endoscopy procedures might be done to monitor people for the development of GISTs.
Screening options may change over time as new technologies are developed and more is learned about primary familial GIST syndrome.
Treatment options for GISTs depend on several factors, including where the tumor(s) is, if it has spread, and if tumors are affecting other parts of the body.
There is some evidence that familial GISTs tend to spread slower than sporadic GISTs, which may affect treatment decisions. Given the rare nature of this disease, people are encouraged to talk with doctors who have specific expertise in this area of medicine.
To learn more about how GISTs are treated, see Treating Gastrointestinal Stromal Tumors.
If you are concerned about your risk of developing a GIST, talk with your health care team. It might be helpful to bring someone along to your appointments to take notes. Consider asking your health care team the following questions:
If you are concerned about your family history and think your family may have primary familial GIST syndrome, consider asking the following questions:
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Last Revised: March 1, 2024
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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