Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study

Abstract

Background/Aims: This study aimed to evaluate the prevalence and natural progression of subepithelial lesions (SELs) in the upper gastrointestinal (UGI) tract.Methods: The medical records of patients with UGI SELs who underwent endoscopic screening at eight university hospitals between January and December 2010 were retrospectively investigated. The follow-up evaluations were performed until December 2016.Results: UGI SELs were found in 1,044 of the 65,233 participants screened (endoscopic prevalence, 1.60%; the total number of lesions, 1,062; mean age, 55.1±11.2 years; men, 53.6%). The median follow-up period was 48 (range, 8–74) months. SELs were most frequently found in the stomach (63.8%) and had a mean size of 9.9±6.1 mm. Endoscopic ultrasonography (EUS) was performed in 293 patients (28.1%). The most common lesions were leiomyomas, followed by gastrointestinal stromal tumors (GISTs), and ectopic pancreas. The proportions of SELs with malignant potential according to size were 3% (<1 cm), 22% (1–2 cm), 27% (2–3 cm), and 38% (≥3 cm). In gastric SELs larger than 1 cm, resections were performed in 20 patients because of an increase in size, of which 12 were found to be GISTs.Conclusions: The prevalence of UGI SELs was 1.60%. Further, 23% of gastric SELs ≥1 cm were precancerous lesions, most followed by EUS and clinical decisions without initial pathological confirmation.

A 65-Year-Old Man Presenting to the Emergency Department with Gastric Hemorrhage Caused by a Glomus Tumor

“…Glomus tumors were first described in 1924 by Masson et al Four years later, Tliejeva et al performed the description of a glomus tumor at the gastric level [ 7 ]. The prevalence of these subepithelial lesions is rarely reported, with studies to date reporting rates between 0.8% and 1.7% [ 6 ]. Localization in the gastrointestinal tract is rare.…”

“…So far, a little over 200 cases have been described in the specialized literature [ 5 ]. At this level, glomus tumors are part of the category of subepithelial lesions of the gastrointestinal tract and are often confused with other more common entities, such as gastrointestinal stromal tumors, neuroendocrine tumors, or lymphomas [ 6 ].…”

Endoscopic treatment of a large Brunner’s gland hamartoma in the duodenum

“…BGH is a benign proliferative disorder of the Brunner’s glands in the duodenum 1 . It is often discovered incidentally during endoscopy, with typical findings indicating mucosal protrusions or polyps 2 . The American Institute of Radiologic Pathology categorizes lesions <5 mm as “Brunner’s gland hyperplasia” and those >5 mm as “BGH” 3 .…”

Artificial Intelligence-Based Diagnosis of Gastric Mesenchymal Tumors Using Digital Endosonography Image Analysis

“…Subepithelial tumors (SETs) are frequently coincidentally discovered during endoscopic examinations of the gastrointestinal (GI) tract. The frequency of upper GI SETs is reported to be 1.6−1.9%; approximately two-thirds of upper GI SETs are present in the stomach [1,2]. Among gastric SETs, gastric mesenchymal tumors originating from the muscularis propria are of major concern in clinical practice.…”