Endoscopic histologic diagnosis of gastric GI submucosal tumors via the endoscopic submucosal dissection technique

Abstract

Submucosal tumors (SMTs) are occasionally found in the esophagus and stomach during upper endoscopy.1 Most SMTs are asymptomatic and therefore clinically insignificant. However, SMTs do have malignancy potential, and therefore it is important to distinguish malignant from benign lesions.2 Among gastric SMTs, GI stromal cell tumors (GISTs) have malignancy potential that is related to tumor size; however, malignancy is occasionally found in smaller lesions.3 EUS can be used to diagnose GISTs preoperatively, although differential diagnosis on the basis of imaging alone is insufficient. However, when EUS is used in combination with EUS-guided FNA (EUS-FNA), diagnostic accuracy increases, although the results can be quite variable.4 Thus, linear type EUS and EUS-FNA needles must be used for EUS-guided biopsy, and there are some limitations when the SMTs are small. We performed endoscopic biopsy of gastric SMTs by using the ESD technique. The aim of this study was to prospectively evaluate both the feasibility and the safety of this method.