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World Journal of Gastrointestinal Surgery 2024年第7期16卷 2351-2357页

作者： Jing-Jie Wang Fen-Ming Zhang Wei Chen Hua-Tuo Zhu Ning-Long Gui Ai-Qing Li Hong-Tan Chen Department of Gastroenterology The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Extragastric lesions are typically not misdiagnosed as gastric submucosal tumor(SMT).However,we encountered two rare cases where extrinsic lesions were misdiagnosed as gastric *** SUMMARY We describe two cases of gastric SMT-like protrusions initially misdiagnosed as gastric SMTs by the abdominal contrast-enhanced computed tomography(CT)and endoscopic ultrasound(EUS).Based on the CT and EUS findings,the patients underwent gastroscopy;however,no tumor was identified after incising the gastric *** surgical exploration revealed no gastric lesions in both patients,but a mass was found in the left triangular ligament of the *** patients underwent laparoscopic tumor resection,and the postoperative diagnosis was hepatic *** During EUS procedures,scanning across different layers and at varying degrees of gastric cavity distension,coupled with meticulous image analysis,has the potential to mitigate the likelihood of such misdiagnoses.

关键词： submucosal tumor Extragastric compression Endoscopic ultrasonography Computed tomography Hemangioma of the left triangular ligament of the liver Case report

Gastric pyloric gland adenoma resembling a submucosal tumor:A case report

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World Journal of Clinical Cases 2020年第11期8卷 2380-2386页

作者： Cong-Cong Min Jun Wu Feng Hou Tao Mao Xiao-Yu Li Xue-Li Ding Hua Liu Department of Gastroenterology The Affiliated Hospital of Qingdao UniversityQingdao 266003Shandong ProvinceChina Department of Pathology The Affiliated Hospital of Qingdao UniversityQingdao 266003Shandong ProvinceChina

BACKGROUND Pyloric gland adenoma(PGA)is a recently described and rare *** tumor(SMT)-like PGA is more difficult to diagnose and differentiate from other submucosal *** SUMMARY We present the case of a 69-year-old man with a 10 mm SMT-like elevated lesion with an opening in the upper part of the gastric body,referred to our hospital for further endoscopic *** endoscopy with narrow-band imaging,endoscopic ultrasonography,and complete endoscopic submucosal dissection were performed on the *** findings revealed tightly packed tubular glands lined with cuboidal or columnar cells that had round-tooval nuclei containing occasional prominent nucleoli and an eosinophilic cytoplasm similar to that in non-neoplastic gastric pyloric ***,immunohistochemical analysis showed positive staining for both mucin 5AC and mucin ***,we arrived at the final diagnosis of gastric *** there was no apparent malignant component in this tumor,PGA has been considered a precancerous disease with a high risk of transformation into *** PGA should be considered when detecting gastric SMT-like *** and pathologists should focus on PGA due to its malignant potential.

关键词： Pyloric gland adenoma submucosal tumor Endoscopic submucosal dissection Case report

Hepatic cyst misdiagnosed as a gastric submucosal tumor:A case report

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World Journal of Gastroenterology 2008年第19期14卷 3092-3094页

作者： Joong-Min Park Jin Kim Ho-Il Kim Chong-Suk Kim Department of Surgery Korea University College of Medicine

We describe here a case of 51-year-old woman with a symptomatic hepatic cyst that was misdiagnosed as a gastric submucosal tumor (SMT) with endoscopic ultrasound (EUS) and CT scan. The patient presented with an epigastric pain for two months. On endoscopy, a submucosal tumor was found on the cardia of the stomach. Based on EUS and abdominal CT scan, the lesion was diagnosed as a gastric duplication cyst or a gastrointestinal stromal tumor (GIST). The operative plan was laparoscopic wedge resection for the GIST of the gastric cardia. A cystic mass arising from the left lateral segment of the liver was found at the laparoscopic examination. There was no abnormal finding at the gastric cardia. She was treated by laparoscopic hepatic wedge resection including the hepatic cyst using an endoscopic linear stapler.

关键词： Hepatic cyst submucosal tumor Stomach

Early gastric cancer presenting as a typical submucosal tumor cured by endoscopic submucosal dissection:A case report

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World Journal of Gastroenterology 2022年第25期28卷 2994-3000页

作者： Joon Hyun Cho Si Hyung Lee Division of Gastroenterology and Hepatology Department of Internal MedicineYeungnam University College of MedicineDaegu 42415South Korea

BACKGROUND submucosal tumor(SMT)-like gastric cancer is rare,and almost all cases undergo curative surgical treatment because the submucosal layer is usually deeply invaded by tumor cells or because histopathologic types of SMT-like gastric cancer are undifferentiated or poorly *** report has been issued on an SMT-like gastric cancer cured by endoscopic resection alone or on changes in the endoscopic features of this type of tumor over several *** SUMMARY We describe an exceptional case of a 53-year-old male with a 1.5 cm-sized SMTlike lesion covered by normal-appearing mucosa discovered by esophagogastroduodenoscopy(EGD)at the gastric *** ultrasound(EUS)visualized a homogeneous,well-circumscribed hypoechogenic lesion arising from the second sonographic layer with associated subtle obliteration of the third sonographic *** endoscopic biopsy was negative for *** patient refused to undergo an invasive procedure and was subsequently lost to *** years after initial detection,EGD revealed the lesion had become markedly erythematous,and at 4 years after initial EGD it had increased in size to 1.8 cm and developed a central ulcer and a heterogeneous EUS ***,endoscopic submucosal dissection(ESD)was performed,and histopathologic examination revealed a moderately differentiated adenocarcinoma had minutely invaded the submucosal layer(invasion depth 169μm)but without lymphovascular invasion and with negative resection ***,no additional surgical treatment was *** has been followed for 4 years after ESD without any evidence of local or distant *** This report describes an extremely rare case of early gastric cancer presenting as SMT that was cured by ESD after a treatment delay of 4 years and the endoscopic changes that occurred during this *** report highlights the importance of considering the possibility of gastric cancer when SMT is encountered in clini

关键词： Subepithelial lesion submucosal tumor Early gastric cancer Adenocarcinoma Endoscopic mucosal dissection Case report

Therapeutic procedures for submucosal tumors in the gastrointestinal tract

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World Journal of Gastroenterology 2007年第24期13卷 3316-3322页

作者： Laura Graves Ponsaing Mark Berner Hansen Department of Surgical Gastroenterology K Bispebjerg University Hospital of Copenhagen Denmark

This review is part three of three and will present an update on the therapeutic options and procedures concerning gastrointestinal (GI) submucosal tumors (SMTs). The aim of this paper is to investigate the treatments of GI SMTs and to present a case of a gastrointestinal stromal tumor (GIST). Literature searches were performed to find information on therapy for GI SMTs. Based on these searches, the optimal therapeutic procedures could be outlined. The choice of treatment of localized tumors is endoscopic resection if possible or, alternatively, laparoscopic resection or surgical resection by an open procedure. However, benign SMTs should only be excised if symptoms are present, and GISTs should be treated with particular precautions. Irresectable or recurrent GISTs may be successfully treated with the tyrosine kinase inhibitor, imatinib.

关键词： submucosal tumor Treatment Case story Endoscopic mucosal resection Imatinib

Diagnostic procedures for submucosal tumors in the gastrointestinal tract

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World Journal of Gastroenterology 2007年第24期13卷 3301-3310页

作者： Laura Graves Ponsaing Katalin Kiss Annika Loft Lise Ingemann Jensen Mark Berner Hansen Department of Surgical Gastroenterology K Bispebjerg University Hospital of Copenhagen Denmark Department of Pathology Herlev University Hospital Gentofte Denmark Department of Nuclear Medicine CopenhagenUniversity Hospital Rigshospitalet Denmark Department of Radiology Bispebjerg University Hospital of Copenhagen Denmark

This review is part one of three, which will present an update on diagnostic procedures for gastrointestinal (GI) submucosal tumors (SMTs). Part two identifies the classification and part three the therapeutic methods regarding GI SMTs. submucosal tumors are typically asymptomatic and therefore encountered incidentally. Advances in diagnostic tools for gastrointestinal submucosal tumors have emerged over the past decade. The aim of this paper is to provide the readers with guidelines for the use of diagnostic procedures, when a submucosal tumor is suspected. Literature searches were performed to find information on diagnostics for gastrointestinal submucosal tumors. Based on the searches, the optimal diagnostic procedures and specific features of the submucosal tumors could be outlined. Standard endoscppy, capsule endoscopy and push-and-pull enteroscopy (PPE) together with barium contrast X-ray do not alone provide sufficient information, when examining submucosal tumors. Endoscopic ultrasound (EUS), computed tomography (CT), magnetic resonance imaging (MRI) and fluorodeoxyglucose-labeled positron emission tomography (FDG-PET) are recommended as supplementary tools.

关键词： submucosal tumor Diagnosis Endoscopy Endoscopic ultrasonography Computed tomography Magnetic resonance imaging Positron emission tomography Capsule endoscopy Push-and-pull enteroscopy Ponsaing LG, Kiss K, Loft A, Jensen LI, Hansen MB.

Classification of submucosal tumors in the gastrointestinal tract

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World Journal of Gastroenterology 2007年第24期13卷 3311-3315页

作者： Laura Graves Ponsaing Katalin Kiss Mark Berner Hansen Department ofSurgical Gastroenterology K Bispebjerg University Hospital ofCopenhagen Denmark Department of Pathology Herlev UniversityHospital Gentofte Denmark

This review is part two of three, which will present an update on the classification of gastrointestinal submucosal tumors. Part one treats of the diagnosis and part three of the therapeutic methods regarding gastrointestinal submucosal tumors. In the past there has been some confusion as to the classification of gastrointestinal submucosal tumors. Changes in classifications have emerged due to recent advances in mainly immunohistochemistry and electron microscopy. The aim of this paper is to update the reader on the current classification. Literature searches were performed to find information related to classification of gastrointestinal submucosal tumors. Based on these searches the twelve most frequent submucosal tumor types were chosen for description of their classification. The factors that indicate whether tumors are benign or malignant are mainly size and number of mitotic counts. Gastrointestinal stromal tumors are defined mainly by their CD117 positivity. In the future, there should be no more confusion between gastrointestinal stromal tumors and other types of submucosal tumors.

关键词： submucosal tumor Immunohistochemistry Smooth muscle derived submucosal tumors submucosal tumors of neurogenic origin Gastrointestinal stromal tumor Malignant Benign

Clinical implications of doubling time of gastrointestinal submucosal tumors

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World Journal of Gastroenterology 2016年第45期22卷 10015-10023页

作者： Shuko Koizumi Mitsuhiro Kida Hiroshi Yamauchi Kosuke Okuwaki Tomohisa Iwai Shiro Miyazawa Miyoko Takezawa Hiroshi Imaizumi Wasaburo Koizumi Department of Gastroenterology Kitasato University School of Medicine

AIM To evaluate the efficacy of doubling time(DT) of gastrointestinal submucosal tumors(GIST).METHODS From April 1987 through November 2012, a total of 323 patients were given a final histopathological diagnosis of GISTs on surgical resection or endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) in Kitasato University East Hospital or Kitasato University Hospital. We studied 53 of these patients(34 with resected tumors and 19 with unresected tumors) whose tumors could be measured on EUS on at least two successive occasions. The histopathological diagnosis was GIST in 34 patients, leiomyoma in 5, schwannoma in 3, ectopic pancreas in 1, hamartoma in 1, cyst in 1, Brunner's adenoma in 1, and spindle-cell tumor in 7. We retrospectively calculated the DT of GISTs on the basis of the time course of EUS findings to estimate the growth rate of such *** The DT was 17.2 mo for GIST, as compared with 231.2 mo for leiomyoma, 104.7 mo for schwannoma, 274.9mo for ectopic pancreas, 61.2 mo for hamartoma, 49.0 mo for cyst, and 134.7 mo for Brunner's adenoma. The GISTs were divided into risk classes on the basis of tumor diameters and mitotic figures(Fletcher's classification). The classification was extremely low risk or low risk in 28 patients, intermediate risk in 3, and high risk in 3. DT of GIST according to risk was 24.0 mo for extremely low-risk plus low-risk GIST, 17.1 mo for intermediate-risk GIST, and 3.9 mo for high-risk GIST. DT of GIST was significantly shorter than that of leiomyoma plus schwannoma(P < 0.05), and DT of high-risk GIST was significantly shorter than that of extremely low-risk plus low-risk GIST(P < 0.05).CONCLUSION For GIST, a higher risk grade was associated with a significantly shorter DT. Small SMTs should initially be followed up within 6 mo after detection.

关键词： Gastrointestinal submucosal tumor Doubling time submucosal tumor Initial observational duration Endoscopic ultrasonography Endoscopic ultrasonography-guided fine needle aspiration Fletcher’s classification

Endoscopic submucosal tunnel dissection of upper gastrointestinal submucosal tumors: A comparative study of hook knife vs hybrid knife

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World Journal of Gastroenterology 2017年第10期23卷 1843-1850页

作者： Jie-qiong Zhou Xiao-Wei tang Yu-tang Ren Zheng-Jie Wei Si-lin Huang qiao-ping Gao Xiao-feng Zhang Jian-feng Yang Wei Gong Bo Jiang Guangdong Provincial key laboratory of Gastroenterology Department of Gastroenterology Nanfang Hospital Southern Medical University Department of Gastroenterology Beijing Tsinghua Changgung Hospital Medical Center Tsinghua University Department of Gastroenterology Hangzhou First People’s Hospital Nanjing Medical University

AIM to compare the efficacy and safety of a hook knife(HO) with a hybrid knife(HK) during endoscopic submucosal tunnel dissection(EStD) *** Between August 2012 and December 2015, the ESt D procedure was performed for 83 upper GI submucosal lesions, which originated from the muscularis propria layer identified by upper endoscopy and endoscopic ultrasonography. Of these, 34 lesions were treated by a HO, whereas 49 lesions were treated by a HK. Data regarding age, gender, presenting symptoms, tumor location and size, procedure time, complications, en bloc resection rate and others were analyzed and compared between the two *** there were no significant differences in the age, gender, presenting symptoms and tumor location between the two groups. EStD was successfully completed in all the patients, and no case was converted to laparoscopy. the mean procedure time was significantly shorter in the HK group than in the HO group(41.3 ± 20.3 min vs 57.2 ± 28.0 min, p = 0.004). the mean frequency of device exchange was 1.4 ± 0.6 in the HK group and significantly less than 3.3 ± 0.6 in the HO group(p tumor size and histopathological diagnoses were not significant between the two groups(p = 0.813, p = 0.363, respectively). Both groups had an equal en bloc resection rate and complete resection rate. Additionally, the complication rate was similar between the two groups(p = 0.901). During the follow-up, no recurrence occurred in either *** We demonstrate for the first time that HO and HK do not differ in efficacy or safety, but HK reduces the frequency of device exchange and procedure time.

关键词： Endoscopic submucosal tunnel dissection submucosal tumor hook knife hybrid knife clinical outcome

Endoscopic full-thickness resection for gastric submucosal tumors arising from the muscularis propria layer

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World Journal of Gastroenterology 2014年第38期20卷 13981-13986页

作者： Liu-Ye Huang Jun Cui Shu-Juan Lin Bo Zhang Cheng-Rong Wu Department of Gastroenterology Yantai Yu Huang Ding Hospital

AIM: To evaluate the efficacy, safety and feasibility of endoscopic full-thickness resection (EFR) for the treatment of gastric submucosal tumors (SMTs) arising from the muscularis propria.

关键词： submucosal tumor Stomach Endoscopic full-thickness resection Muscularis propria layer Excision