Clinical course of asymptomatic duodenal subepithelial lesions
- Author:
Seokin KANG
1
;
Kwangbeom PARK
;
Do Hoon KIM
;
Yuri KIM
;
Hee Kyong NA
;
Jeong Hoon LEE
;
Ji Yong AHN
;
Kee Wook JUNG
;
Kee Don CHOI
;
Ho June SONG
;
Gin Hyug LEE
;
Hwoon-Yong JUNG
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2024;39(4):603-611
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Background/Aims:There is limited knowledge regarding the management of duodenal subepithelial lesions (SELs) owing to a lack of understanding of their natural course. This study aimed to assess the natural course of asymptomatic duodenal SELs and provide management recommendations.
Methods:Patients diagnosed with duodenal SELs and followed up for a minimum of 6 months were retrospectively investigated.
Results:Among the 443,533 patients who underwent esophagogastroduodenoscopy between 2008 and 2020, duodenal SELs were identified in 0.39% (1,713 patients). Among them, 396 duodenal SELs were monitored for a median period of 72.5 months (interquartile range, 37.7–111.3 mo). Of them, 16 SELs (4.0%) showed substantial changes in size or morphology at a median follow-up of 35.1 months (interquartile range, 21.7–51.4 mo). Of these SELs with substantial changes, tissues of two SELs were acquired using endoscopic ultrasound-guided fine needle aspiration biopsy: one was a lipoma and the other was non-diagnostic. Three SELs were surgically or endoscopically removed; two were diagnosed as gastrointestinal stromal tumors, and one was a lipoma. An initial size of 20 mm or larger was associated with substantial changes during follow-up (p = 0.016).
Conclusions:While the majority of duodenal SELs may not exhibit substantial interval changes, regular follow-up with endoscopy may be necessary for cases with an initial size of 20 mm or larger, considering a possibility of malignancy.
