Gastric fundal splenosis presenting as a stromal tumor and diagnosed by endoscopic ultrasound-guided SharkCore biopsy

Barbuscio, I.; Fantin, Alberto; Ghisa, Matteo; Savarino, Edoardo; Mescoli, Claudia; Farinati, Fabio

doi:10.1055/a-0866-8930

Cited by 5 publications

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“…In this study, 43 patients were diagnosed as leiomyoma, among which 41 cases were diagnosed as stromal tumor by EUS before operation, and the coincidence rate was only 4.65%, which was similar to that of Zhu Lanping [11]. Leiomyoma is easy to be misdiagnosed because of its EUS features, such as more than stomach body and fundus, multiple origins from muscularis propria, uniform hypoechoic, no vascular shadow and clear boundary, which are very similar to those of stromal tumors [14]. Further research by Ma Dong [15] found that if EUS found that the tumor was 2cm in diameter, with uneven echo and calci cation, it was more likely to be a stromal tumor.…”

Section: Discussionsupporting

confidence: 64%

Value of Endoscopic Ultrasonography in Diagnosis and Invasion Risk Classification of Submucosal Tumors

Ning

2023

Preprint

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Objective:To explore the value of endoscopic ultrasonography (EUS) in the diagnosis and invasion risk classification of submucosal tumor (SMT). Method:197 patients with gastric SMT diagnosed by EUS in Second Affiliated Hospital of Chongqing Medical University were enrolled by retrospective study, with a total of 197 lesions.Taking the results of pathological examination as the diagnostic gold standard, the coincidence rate of EUS diagnosis and pathological examination results in patients with gastric SMT was calculated.The demographic data and EUS characteristics of patients were collected, and the patients with gastric SMT were divided into coincidence group and non-coincidence group, and the factors affecting the coincidence rate were analyzed.Patients with gastric stromal tumor(GST) and other types of gastric SMT were divided into very low, low, medium and high-risk groups, and the factors predicting the invasion risk classificationwere analyzed.Finally, the coincidence rate between the preoperative plan based on EUS diagnosis and the final actual surgical plan is calculated. Result:The coincidence rate of EUS diagnosis and pathological examination results in patients with gastric SMT was 69.04%(136/197).The coincidence ratewas higher in older patients over 60(P<0.05). The proportion of ultrasonic inhomogeneity inside the lesions that meet the diagnosis is significantly higher than that inside the lesions that do not meet the diagnosis (P<0.05).The patient's age > 60 years old and the ultrasonic inhomogeneitywere independent influencing factors of the coincidence rate (P<0.05).The higher the risk of invasion, the more common ultrasonic inhomogeneity, blood flow signal inside the lesions and unclear boundary (P<0.05).Ultrasonic inhomogeneity and blood flow signal inside the lesions were independent influencing factors to predict the invasion risk classification(P<0.05).One patient failed to isolate the lesion during the surgery, and the others were successful.The coincidence rate of surgical plan was 99.49%(196/197). Conclusion:The results of EUS diagnosis and pathological examination in patients with gastric SMT have good consistency.The patient's age is over 60 years old, ultrasonic inhomogeneityinside the lesions, and the coincidence rate of EUS is higher.The EUS characteristics of gastric SMT patients with different invasion risk classification are different.Ultrasonic inhomogeneityand blood flow signal inside the lesions are important signs to predict the invasion risk classification.EUS can help doctors choose the surgical plan.

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Section: Discussionsupporting

confidence: 64%

Value of Endoscopic Ultrasonography in Diagnosis and Invasion Risk Classification of Submucosal Tumors

Ning

2023

Preprint

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“…It was initially described in 1937 [ 2 ]. It is mostly seen in the abdominal and pelvic cavity including the greater omentum, serosa of the intestines, mesentery, parietal peritoneum, and diaphragm [ 3 , 5 ]. Other sites such as intrathoracic, gastric, intrahepatic, kidney, brain, and lungs have also been described [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Gastric Splenosis Mimicking Gastrointestinal Stromal Tumor

Kanagalingam¹,

Vyas²,

Sostre³

et al. 2021

Cureus

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Translocation of splenic tissue in patients after traumatic spleen injury or splenectomy is called splenosis. Gastric splenosis is a rare presentation that can be mistaken for gastrointestinal stromal tumor (GIST). Patients are usually asymptomatic and do not require surgical intervention. In this report, we present a case of a 68-year-old male patient with a previous history of surgical splenectomy after traumatic splenic rupture, who underwent routine upper endoscopy for the evaluation of dysphagia. An endoscopic exam of the stomach revealed an incidental finding of a submucosal gastric nodule. On endoscopic ultrasound exam, the lesion was found to be suggestive of GIST originating from layer 4. A core biopsy was obtained from the nodule, which was consistent with gastric splenosis. The differentiation of gastric splenosis from other gastric lesions such as GIST is important since asymptomatic patients with gastric splenosis do not need to undergo surveillance or surgical resection. It should be suspected especially in patients with a history of splenectomy or splenic rupture. Endoscopic ultrasound (EUS)-guided core biopsy can help confirm the diagnosis and differentiate the condition from GIST.

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“…S1. The first author, publication year and country of each case, along with the patient's age, gender, main clinical symptoms, medical history, lesion size and findings from gastroscopic, ultrasonic and CT imaging, were meticulously recorded, as depicted in Table I (4,6,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Through a systematic search, a total of 22 cases of gastric splenosis and intragastric splenosis were definitively confirmed from the published literature.…”

Section: Literature Reviewmentioning

confidence: 99%

A large gastric splenosis mimicking gastrointestinal stromal tumor: A case report and literature review

Li,

Hu,

Wang

et al. 2024

Exp Ther Med

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Splenosis pertains to the phenomenon wherein a segment of the spleen undergoes detachment and becomes embedded in other anatomical regions subsequent to traumatic rupture or therapeutic resection, and then progressively establishing blood circulation to foster the regeneration of splenic tissue. Existing literature posits that splenosis predominantly manifests within the confines of the abdominal and pelvic cavities. The objective of the current study was to present an uncommon case involving the occurrence of splenosis within the gastric myometrium, thereby contributing to the current knowledge regarding splenosis. A 16-year-old female sought medical assistance owing to recurrent abdominal pain persisting for a duration of six months, and had a history of splenectomy two years prior. Gastroscopy, endoscopic ultrasound and computed tomography (CT) examination collectively identified a lesion in the submucosal prominence of the fundus of the stomach. Initial considerations based on imaging examinations leaned towards a gastrointestinal stromal tumor. Consequently, an endoscopic resection was undertaken. Remarkably, the pathological findings and histochemistry concurred with the alterations associated with ectopic spleen implantation, leading to a stable postoperative course. In conclusion, splenosis denotes the implantation of a segment of the spleen into extraneous anatomical sites, attributable to traumatic rupture or therapeutic resection. The preoperative diagnosis of splenosis can pose a challenge, potentially culminating in unnecessary radical clinical interventions. Therefore, the acquisition of a comprehensive medical history, with a particular focus on surgical and trauma events, emerges as pivotal for an accurate diagnosis. In light of novel diagnostic modalities, the non-invasive technology of nuclear medicine can efficaciously visualize ectopic splenic tissue, thereby averting superfluous surgical procedures. It is both feasible and imperative to implement individualized treatment strategies for patients afflicted with splenosis.

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Gastric fundal splenosis presenting as a stromal tumor and diagnosed by endoscopic ultrasound-guided SharkCore biopsy

Abstract: Barbuscio Ilenia et al. Gastric fundal splenosis diagnosed by EUS biopsy … Endoscopy 2019; 51: E160-E161 This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

Cited by 5 publications

References 0 publications

Value of Endoscopic Ultrasonography in Diagnosis and Invasion Risk Classification of Submucosal Tumors

Value of Endoscopic Ultrasonography in Diagnosis and Invasion Risk Classification of Submucosal Tumors

Gastric Splenosis Mimicking Gastrointestinal Stromal Tumor

A large gastric splenosis mimicking gastrointestinal stromal tumor: A case report and literature review

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