Gastrointestinal stromal tumor of the esophagus: current issues of diagnosis, surgery and drug therapy

Hihara, Jun; Mukaida, Hidenori; Hirabayashi, Naoki

doi:10.21037/tgh.2018.01.06

Cited by 39 publications

(30 citation statements)

References 53 publications

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“…CT scan and Magnetic resonance imaging, EUS are recommended for the diagnosis of GIST, but it is difficult to distinguish them from other submucosal tumors by imaging alone. EUS-FNA is the only useful diagnostic method, but the available facilities are limited and involve the risk of dissemination [5] . Generally, complete surgical resection is the standard of treatment for primary GIST because of malignant potential.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted thoracoscopic esophagectomy for gastrointestinal stromal tumor of the esophagus: A case report

Yamamoto

Ebihara

Tanaka

et al. 2021

International Journal of Surgery Case Reports

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Introduction A gastrointestinal stromal tumor (GIST) often arises in the stomach and small intestine, while esophageal GIST is rare. The first-choice treatment is surgical resection, but there is no standard technique. Herein, we describe our experience in the treatment of esophageal GIST and discuss the usefulness of robotic esophagectomy. Presentation of case The patient was a 60-year-old woman, who was diagnosed with a 30 mm GIST in the middle thoracic esophagus. We underwent robot-assisted thoracoscopic esophagectomy in the prone position. The duration of the thoracoscopic part was 69 min and the total operation time was 319 min. Total blood loss was 135 ml. The patient's postoperative course was uneventful after surgery and the patient was discharged home in good condition on the 18th postoperative day. Discussion The prognosis of esophageal GIST was less favorable compared with gastric GIST, and due to the anatomical peculiarities of the esophagus, which surgical procedure should be performed is still under debate. Robotic surgery has several technological advantages as it provides a three-dimensional view, ten times magnification, tremor control, and ambidexterity. Therefore, Robotic-assisted minimally invasive esophagectomy (RAMIE) allows achieving for safe R0 resection of esophageal GIST. Conclusion RAMIE may be useful for esophageal GIST because it facilitates safe and minimally invasive surgery in a limited space of the thoracic cavity.

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Section: Discussionmentioning

confidence: 99%

Robot-assisted thoracoscopic esophagectomy for gastrointestinal stromal tumor of the esophagus: A case report

Yamamoto

Ebihara

Tanaka

et al. 2021

International Journal of Surgery Case Reports

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show abstract

“…GISTs that form outside of the GI tract, namely esophageal GISTs, are rare and therefore poorly diagnosed. The lack of clinicopathological data impedes the identification and surgical resection of GISTs [67]. Although PET, CT, and endoscopy are most commonly used for GIST diagnosis, they are not ideal methods due to high radiation exposure and low GIST specificity [68].…”

Section: Intraoperative Thoracic Tumor Diagnosis and Surgerymentioning

confidence: 99%

Real-Time Fluorescence Imaging in Thoracic Surgery

Das

Santos

Park

et al. 2019

Korean J Thorac Cardiovasc Surg

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Near-infrared (NIR) fluorescence imaging provides a safe and cost-efficient method for immediate data acquisition and visualization of tissues, with technical advantages including minimal autofluorescence, reduced photon absorption, and low scattering in tissue. In this review, we introduce recent advances in NIR fluorescence imaging systems for thoracic surgery that improve the identification of vital tissues and facilitate the resection of tumorous tissues. When coupled with appropriate NIR fluorophores, NIR fluorescence imaging may transform current intraoperative thoracic surgery methods by enhancing the precision of surgical procedures and augmenting postoperative outcomes through improvements in diagnostic accuracy and reductions in the remission rate.

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“…[ 3 ] In addition, EUS-FNA can destroy the tumor capsule, which might lead to the increase in the risk of tumor rupture and seeding. [ 7 ] During recent years, with the development of endoscopic technology, endoscopic submucosal dissection (ESD) and submucosal tunnel endoscopic resection can achieve complete resection. This has led to the correct diagnosis of several malignant SELs that lacked specific endoscopic presentations.…”

Section: Introductionmentioning

confidence: 99%

Esophageal intramural squamous cell carcinomas presenting as subepithelial lesions removed by endoscopic submucosal dissection

Zhu

Shi

et al. 2020

Medicine

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Introduction: Esophageal subepithelial lesions (SELs) are rare, and the majority of them are benign. SELs are often covered with normal mucosa, thereby resulting in some malignant SELs to be easily missed or misdiagnosed. We report 2 cases of esophageal intramural squamous cell carcinomas (SCCs) that presented as SELs and were endoscopically removed. Patient concerns: Case 1 is a 63-year-old man with abdominal distension; case 2 is a 65-year-old man with increasing dysphagia for 2 months. Diagnosis: In case 1, endoscopy showed a 1.5-cm mucosal eminence with normal overlying mucosa. Endoscopic ultrasound (EUS) revealed that it might be derived from the muscularis mucosa or submucosa. In case 2, endoscopy revealed a 1.2-cm hemispherical lesion covered with smooth mucosa. Furthermore, EUS revealed that this lesion might be derived from the submucosa. Interventions: In both cases, the lesions were removed by endoscopic submucosal dissection (ESD). Pathological examination revealed esophageal SCC nests with intramural growth patterns. Outcomes: The first patient underwent postoperative radiotherapy, whereas the second patient did not receive any additional treatment. Both patients agreed to regular follow-up, and no tumor recurrence or metastasis was observed. Conclusion: First, not all esophageal SELs are benign, and a small number of SELs can be malignant. Second, these cases illustrate the value of newer endoscopic techniques, especially ESD. Thus, it is important to be alert when visualizing the esophagus for the possibility of a subtle SEL so that further evaluation and treatment, if necessary, can be undertaken, ideally with a less invasive approach afforded by ESD.

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Gastrointestinal stromal tumor of the esophagus: current issues of diagnosis, surgery and drug therapy

Cited by 39 publications

References 53 publications

Robot-assisted thoracoscopic esophagectomy for gastrointestinal stromal tumor of the esophagus: A case report

Robot-assisted thoracoscopic esophagectomy for gastrointestinal stromal tumor of the esophagus: A case report

Real-Time Fluorescence Imaging in Thoracic Surgery

Esophageal intramural squamous cell carcinomas presenting as subepithelial lesions removed by endoscopic submucosal dissection

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