Current Status of Endoscopic Ultrasonography in Gastrointestinal Subepithelial Tumors

Abstract

Gastrointestinal subepithelial tumors (GSTs) are usually detected incidentally on endoscopic or radiologic examinations. In conventional endoscopy, a GST usually presents as a protuberant lesion with an intact mucosal surface. As the lesion is located beneath the mucosal layer of the gastrointestinal tract, conventional biopsy typically does not reveal the pathologic diagnosis. First, a GST should be differentiated from an extrinsic compression through the positional change of the patient during conventional endoscopic examination. In cases of GSTs originating from the gastrointestinal wall, endoscopic ultrasonography (EUS) can be beneficial for narrowing the differential diagnosis through delineation of echo findings and by determining the layer of origin. EUS findings can also help determine the management strategies for GSTs by making a differential diagnosis according to malignant potential.

Traumatic neuroma of remnant cystic duct mimicking duodenal subepithelial tumor: A case report

“…In general, non-neoplastic GST is caused by compression by extra-GI organs, malignant tumors, or benign pathologic lesions[ 5 , 12 ]. It has been reported in previous studies that further evaluation using techniques such as EUS, EUS-guided fine-needle aspiration, and abdominal CT is recommended to obtain additional information about the lesion for differential diagnosis[ 1 , 4 , 5 ]. In this case, we performed EUS and abdominal CT to obtain more information on the lesion.…”

“…According to several previous studies, GSTs are found in 0.36%-1.94% of upper GI endoscopy procedures depending on patient characteristics[ 2 , 3 ]. Although GSTs can cause GI symptoms such as abdominal pain, bleeding, GI tract obstruction, and weight loss, most patients with GSTs have no symptoms or signs specific to the disease, and GSTs are generally incidental findings during upper GI endoscopy[ 4 ]. The prevalence of GST has been increasing due to endoscopic screening for medical examinations[ 3 , 4 ].…”

“…Although GSTs can cause GI symptoms such as abdominal pain, bleeding, GI tract obstruction, and weight loss, most patients with GSTs have no symptoms or signs specific to the disease, and GSTs are generally incidental findings during upper GI endoscopy[ 4 ]. The prevalence of GST has been increasing due to endoscopic screening for medical examinations[ 3 , 4 ]. The indication for surgical resection is symptomatic GST, histologically diagnosed as a malignant or potentially malignant tumor such as a gastrointestinal stromal tumor (GIST) or neuroendocrine tumor.…”

Endoscopic Resection of Upper Gastrointestinal Subepithelial Tumours: Our Clinical Experience and Results

“…In addition, histopathological sampling can be done before the procedure with endoscopic ultrasound-guided fine needle aspiration and biopsy. For this reason, it can be considered in experienced centers together with interventional endoscopic procedures (Kim et al, 2019). In this study, CT imaging and routine endoscopy were performed pre-interventional and the patients were informed about not performing EUS and their consent was obtained.…”