The Korean Journal of Helicobacter and Upper Gastrointestinal Research (Sep 2021)

The Pathologic Confirmation in Subepithelial Tumors

  • Kwan Hong Lee,
  • Chan Kyoo Yoo,
  • Hang Lak Lee,
  • Kang Nyeong Lee,
  • Dae Won Jun,
  • Oh Young Lee,
  • Dong Soo Han,
  • Byung Chul Yoon,
  • Ho Soon Choi,
  • Jai Hoon Yoon

DOI
https://doi.org/10.7704/kjhugr.2020.0067
Journal volume & issue
Vol. 21, no. 3
pp. 215 – 219

Abstract

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Background/Aims Subepithelial tumors (SETs) are small, mostly asymptomatic lesions with normal overlying mucosa, usually identified incidentally on endoscopy. The aim of this study was to evaluate the pathologic diagnosis of SETs, and to assess the diagnostic yield and impact of endoscopic submucosal dissection (ESD) biopsy on the management of patients with SETs. Materials and Methods We included 52 subepithelial lesions in this study during the study period. Inclusion criteria included size of the SET >2 cm, and a gastrointestinal stromal tumor (GIST) that cannot be excluded using EUS. We performed an endoscopic biopsy of each SET using the ESD technique. Results The mean diameter of the lesions was 24.15±6.0 mm. The diagnostic yield of this method was 96.15%. Among the 52 participants, 45 were located in the stomach, four in the esophagus, and three in the duodenum. The pathologic diagnoses included: 17 leiomyomas, 13 GISTs, 11 ectopic pancreases, two carcinomas, two inflammatory fibroid polyps, two Brunner’s gland hyperplasia, two lipomas, one glomus tumor, and two remained undiagnosed. The mean duration of the procedure was 13.44±2.41 minutes. Three complications were associated with the procedure. Conclusions Deep biopsy via ESD is useful in determining the histopathologic nature of SETs. This method minimizes the need for unnecessary surgery in benign SETs.

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