Gastrointestinal Neoplasms ; Humans ; Intestinal Neoplasms/surgery* ; Neuroendocrine Tumors/pathology* ; Pancreatic Neoplasms/surgery* ; Stomach Neoplasms/pathology*

Some special types of stomach tumors are often encountered in clinical paractice, such as gastrointestinal stromal tumor (GIST), gastric neuroendocrine tumors (NETs), primary gastric lymphoma (PGL) and some special types of gastric cancer. Because of their special pathogenesis and pathological types with lower incidence, the choices of the treatment for these diseases are limited. This article analyzes these special types of stomach tumors in order to improve the understanding of doctors in these diseases.
Gastrointestinal Stromal Tumors ; pathology ; surgery ; Humans ; Lymphoma ; pathology ; surgery ; Neuroendocrine Tumors ; pathology ; surgery ; Stomach Neoplasms ; pathology ; surgery

Gastrointestinal Neoplasms ; pathology ; Humans ; Neoplasm Recurrence, Local ; surgery ; Postoperative Period

Gastric lymphangioma is a rare benign gastric tumor composed of unilocular or multilocular lymphatic spaces. On gastrofiberscopy a submucosal tumor covered with smooth transparent normal mucosa is revealed in the stomach with or without a stalk. Endoscopic ultrasonography has become an indispensable tool for differentiating these gastric tumors. Treatment of lymphangioma depends on its size, location, and presence of complications. Endoscopic resection is safe and easy and plays an important role in confirming the diagnosis and treatment of the tumors especially of small-sized ones. We report a case of gastric lymphangioma in a 68-yr-old woman who presented with nausea and vague epigastric discomfort for two months. She was diagnosed by gastrofiberscopy with endoscopic ultrasonography and treated successfully with endoscopic resection by strip biopsy method.
Aged ; Biopsy ; Endoscopy, Gastrointestinal ; Endosonography ; Female ; Human ; Lymphangioma/*pathology/surgery/ultrasonography ; Stomach Neoplasms/*pathology/surgery/ultrasonography

A 39-year-old man presented with dizziness and melena for 2 months. Abdominal CT scan showed constrictive wall thickening with enhancement and proximal loop dilatation of the jejunum. On endoscopic examination, there was large amount of bile stained fluid in duodenum. Enteroscopy using pediatric colonoscope demonstrated an encircling mass with obstruction approximately 20 cm distal to the ligament of Treitz. Endoscopic jejunal biopsy showed moderately differentiated adenocarcinoma. Small intestinal adenocarcinoma is uncommonly encountered in clinical practice. Because small intestine is relatively inaccessible via routine endoscopy, diagnosis of small intestinal neoplasm is often delayed for several months after the onset of symptoms. Most of the patients are diagnosed in advanced stage. Therefore, when a small bowel neoplasm is suspected, enteroscopy is the most useful study. If enteroscope is not available, enteroscopy using pediatric colonoscope may permit earlier preoperative diagnosis. We report a case of primary jejunal adenocarcinoma diagnosed by endoscopic biopsy using pediatric colonoscope.
Adenocarcinoma/*pathology/radiography/surgery ; Adult ; Colonoscopes ; Endoscopy, Gastrointestinal ; Humans ; Jejunal Neoplasms/*pathology/radiography/surgery ; Male

At the end of 2012, Chinese Society of Clinical Oncology (CSCO) amended and revised the expert consensus of gastrointestinal stromal tumor (GIST) 2011. This article is respectively review hot topics regarding surgical intervention during the revision, including principles and indications of biopsy and surgery.
Biopsy ; Consensus Development Conferences as Topic ; Gastrointestinal Neoplasms ; diagnosis ; pathology ; surgery ; Gastrointestinal Stromal Tumors ; diagnosis ; pathology ; surgery ; Humans

It is widely accepted that endoscopic submucosal dissection (ESD) is an important treatment option for cases of early gastric carcinoma where the probability of lymph node metastasis is very low. The resected ESD specimens are carefully examined by serial sections at 2 mm intervals, and if pathology reveals submucosal invasion more than 500microm and/or lymphovascular invasion, or if the resection margin is involved by the tumor, surgery is recommended. In this point of view, thorough pathologic examination and reporting the accurate pathologic diagnosis of ESD specimen is very important. The diagnostic approach and pitfalls in the diagnosis of ESD specimen are reviewed.
*Dissection ; Embolism/pathology ; Endoscopy, Gastrointestinal ; Gastric Mucosa/*pathology/surgery ; Humans ; Lymphatic Metastasis/pathology ; Stomach Neoplasms/*pathology/surgery

Sentinel lymph node biopsy has been found to be highly effective in correctly predicting the nodal status of melanoma and breast cancer patients. Recently, individualized surgical treatments based on the actual metastatic status have been introduced in patients with melanoma and breast cancer. Although several promising results of extensive lymph node dissection have been reported in the field of gastrointestinal (GI) cancer, prognostic benefits of extensive surgery are still not validated by prospective randomized trials. Many feasibility studies favoring sentinel node biopsy in various organs have been reported. Although more evidence from large-scale multicenter clinical trials is required, sentinel lymph node mapping might be also widely acceptable for GI cancer.
Colorectal Neoplasms/surgery ; Esophageal Neoplasms/surgery ; Gastrointestinal Neoplasms/pathology/*surgery ; Humans ; Sentinel Lymph Node Biopsy/*methods ; Stomach Neoplasms/pathology/surgery ; Surgical Procedures, Minimally Invasive/methods

BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) has been widely accepted as a curative treatment of early gastric cancer (EGC). The aim of this study was to determine the usefulness and limitations of EMR for treatment of EGC by analyzing our own experience. METHODS: We retrospectively evaluated 51 EGC lesions (45 mucosal and 6 submucosal cancers) from 49 patients who had undergone EMR between Oct. 1997 and Aug. 2002 at Inha Universtiy Hospital. RESULTS: Among 45 lesions of mucosal cancer, enbloc resection was performed in 13 lesions and piecemeal resection in 32 lesions. Complete resection rates of enbloc and piecemeal resection were 84.6% and 43.8%, respectively (p=0.012). Complete resection rate of the lesions smaller than 1 cm in size was 71.4%, 1 to 2 cm in size 52%, and greazter than 2 cm in size 37.5%. Complete resection rates of well, moderately, and poorly differentiated EGC were 59.4%, 71.4%, and 16.7%, respectively (p=0.048). Thirty-three patients underwent a follow-up endoscopy at I month after EMR and two were found to have residual cancers. One patient who had a piecemeal EMR showed cerical and abdominal lymph node metastasis 10 months after EMR. CONCLUSIONS: In selected patients with EGC, EMR can be a curative treatment modality. However, complete resection rate is low in large sized and poorly differentiated EGCs and when piecemeal resection is performed.
Aged ; *Endoscopy, Gastrointestinal ; Female ; Gastric Mucosa/*surgery ; Humans ; Male ; Retrospective Studies ; Stomach Neoplasms/pathology/*surgery

Adult ; Antigens, Neoplasm ; metabolism ; Gastrointestinal Neoplasms ; metabolism ; pathology ; surgery ; Gastrointestinal Stromal Tumors ; pathology ; Humans ; MART-1 Antigen ; Male ; Neoplasm Proteins ; metabolism ; Osteoclasts ; pathology ; S100 Proteins ; metabolism ; Sarcoma, Clear Cell ; metabolism ; pathology ; surgery ; Soft Tissue Neoplasms ; metabolism ; pathology ; surgery