Pathologic analysis of total 52 upper gastrointestinal subepithelial tumors

Abstract

Background & Aims Subepithelial tumors (SETs) are small, mostly asymptomatic lesions with normal overlying mucosa that are usually identified incidentally on endoscopy. The aim of this study is to evaluate the importance of pathologic confirmation in patients with SETs. And we also evaluate the diagnostic yield and impact of an endoscopic submucosal dissection (ESD) biopsy technique on the clinical management of patients with SETs. Patients & Methods A total of 52 subepithelial lesions were included in this study during the study period. Inclusion criteria were that the size of SET was above 2 cm size and Gastrointestinal stromal tumors (GISTs) cannot be excluded in Endoscopic ultrasonography(EUS) finding. We performed an endoscopic biopsy of each SET using the ESD technique. Results The mean diameter of the SETs was 24.15 ± 6.0 mm. The diagnostic yield of this method was 96.15 % (50/52). Of the 52 SETs, 45 were located in the stomach, four in the esophagus, and three in the duodenum. Their pathologic diagnoses were as follows: 17 leiomyomas, 13 GISTs, 11 ectopic pancreases, 2 carcinomas, 2 inflammatory fibroid polyps, 2 Brunner’s gland hyperplasias, 2 lipomas, 1 glomus tumor, and 2 remained undiagnosed. The mean procedure time was 13.44 ± 2.41 minutes. There were three complications associated with this procedure. Discussion Deep biopsy via ESD is useful than Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in determining the histopathologic nature of an SET. This method can reduce the need for unnecessary surgery for benign SETs.