Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal subepithelial tumors of the gastrointestinal tract. GISTs have malignant potential, with size (>5 cm) and mitotic count (>5/50 high-power fields) the most useful predictors of malignant behavior.1 The management of localized GISTs has traditionally been surgical resection with avoidance of tumor rupture. In the era of modern medicine, we are encountering older patients with a higher proportion of comorbidities that have significant perioperative surgical risk.