Surgical resection is the treatment of choice for the gastrointestinal stromal 
tumors (GISTs). In the literature, the 5-year patient survival after surgical 
resection, ranged from 48 to 80%, before the era of imatinib mesylate and the 
exploration of the prognostication criteria. Imatinib mesylate targets an 
intracellular signaling molecule of the natural history and malignant 
development of GISTs, and increased the 5-year survival rate, after the 
resection of primary low-risk GISTs, to similar values to the normal population. 
For high-risk GISTs, current knowledge which is still under expansion, show 
major improvement at the 1-year survival rate of more than 90% versus less than 
50% before imatinib era. After surgical resection, for both low and high 
malignant potential GISTs, a closed control directed to the early identification 
of confined resectable recurrences, is required. This paper assesses the current 
knowledge of GIST management, motivated by a case of patient with intermediate 
risk GIST.