No abstract available.
*Endosonography ; Humans ; Neoplasm Staging ; Sensitivity and Specificity ; Stomach Neoplasms/pathology/*ultrasonography

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

Incidental gastrointestinal subepithelial mass is increasing with national cancer screening endoscopy. Most of gastrointestinal subepithelial mass are small-sized and asymptomatic tumor with benign nature, but gastrointestinal stromal tumor should be ruled-out because of its malignant behavior. Although conventional endoscopy alone can differentiate the nature of subepithelial mass, more accurate diagnosis can be achieved with endoscopic ultrasonography and its guided biopsy. In this review, differential diagnosis and treatment strategy of incidental gastrointestinal subepithelial mass would be presented.
Diagnosis, Differential ; Endoscopy, Gastrointestinal ; Gastrointestinal Stromal Tumors/*diagnosis/pathology/ultrasonography ; Humans ; Intestinal Neoplasms/diagnosis/pathology/ultrasonography ; Stomach Neoplasms/diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

Glomus tumor is a tumor arising from glomus body, a nodular form of arteriolovenular anastomosis that functions to regulate blood flow according to temperature. Gastrointestinal glomus tumors are rare and most frequently occur in the stomach as a subepithelial tumor. A 46-year-old woman presented with an incidental finding of a subepithelial tumor in the stomach. Endoscopic ultrasonography (EUS) showed a 1.4x1 cm sized well circumscribed heterogeneous hypoechoic tumor with a few tubular structures in the fourth sonographic layer of the gastric wall. Characteristically, more hypoechoic halo equal to the echogenecity of proper muscle layer enclosed the tumor. Contrast enhanced abdominal computerized tomography (CT) revealed high enhancement of tumor up to the same level of portal vein in arterial phase and this enhancement persisted to portal phase. For histolgogic confirmation and treatment, endoscopic enucleation was attempted but failed due to fibrotic adhesion with the surrounding tissue. Histologic findings of biopsy specimen were compatible with glomus tumor. Although it is difficult to diagnose glomus tumor preoperatively, these characteristic findings in EUS and CT seem to be useful in distinguishing glomus tumor from other tumors arising from the fourth sonographic layer of gastric wall.
Female ; Glomus Tumor/*diagnosis/pathology/ultrasonography ; Humans ; Middle Aged ; Stomach Neoplasms/*diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

BACKGROUND/AIMS: Subepithelial tumors are occasionally found during upper gastrointestinal endoscopy. The purpose of this study was to evaluate endoscopic characteristics of mesenchymal tumors originating from muscularis mucosa or muscularis propria. METHODS: A total of 307 mesenchymal tumors of the upper gastrointestinal tract were diagnosed between March 2006 and February 2012 at Yeouido St. Mary's Hospital (Seoul, Korea). Data on endoscopic and endoscopic ultrasonographic findings were collected and analyzed by retrospectively reviewing the medical records. RESULTS: The mean size of the mesenchymal tumors originating from muscularis mucosa was significantly smaller than those originating from muscularis propria (10.5+/-6.9 mm vs. 14.3+/-13.9 mm, p=0.035). The most common locations of the mesenchymal tumors originating from muscularis mucosa and muscularis propria were esophagus (69.1%) and body of the stomach (43.3%), respectively (p<0.001). Rolling sign was more commonly observed with mesenchymal tumors originating from muscularis mucosa (80.4%, p=0.001), and cushion sign was more frequently absent with those originating from muscularis propria (72.4%, p<0.001). Internal echo was homogenous in 89.7% and 81.9% of mesenchymal tumors originating from muscularis mucosa and muscularis propria, respectively (p=0.092). CONCLUSIONS: The size, location, and movability of mesenchymal tumors originating from muscularis mucosa were different from those of mesenchymal tumor originating from muscularis propria.propria.
Adult ; Aged ; Aged, 80 and over ; Esophagus/pathology/ultrasonography ; Female ; Gastrointestinal Neoplasms/*diagnosis/pathology/ultrasonography ; Gastrointestinal Stromal Tumors/*diagnosis/pathology/ultrasonography ; Gastroscopy ; Humans ; Male ; Middle Aged ; Mucous Membrane/pathology ; Retrospective Studies ; Stomach/pathology/ultrasonography

No abstract available.
Gastroscopy ; Glomus Tumor/pathology/*radiography/ultrasonography ; Hemangioma/radiography ; Humans ; Liver Neoplasms/radiography ; Male ; Middle Aged ; Stomach Neoplasms/pathology/*radiography/ultrasonography ; Tomography, X-Ray Computed

An inverted hyperplastic polyp (IHP) found in stomach is rare and characterized by downward growth of hyperplastic mucosal component into the submucosa. Because of such characteristic, IHP can be misdiagnosed as subepithelial tumor or malignant tumor. In fact, adenocarcinoma was reported to have coexisted with gastric IHP in several previous reports. Because only 18 cases on gastric IHP have been reported in English and Korean literature until now, pathogenesis and clinical features of gastric IHP and correlation with adenocarcinoma have not been clearly established. Herein, we report a case of gastric IHP which was initially misdiagnosed as gastrointestinal stromal tumor and resected using endoscopic submucosal dissection. Literature review of previously published case reports on gastric IHP is also presented.
Adult ; Gastric Mucosa/pathology/surgery ; Humans ; Hyperplasia/*diagnosis/diagnostic imaging ; Male ; Polyps/pathology/surgery ; Stomach/diagnostic imaging ; Stomach Neoplasms/diagnosis/diagnostic imaging/pathology ; Tomography, X-Ray Computed ; Ultrasonography

Mucinous gastric carcinoma (MGC) is an unusual histologic subtype, and early detection of MGC is very rare. Early-stage MGC appears as an elevated lesion resembling a submucosal tumor (SMT) due to abundant mucin pools in the submucosa or mucosa. We report a rare case of SMT-like early-stage MGC. Tumor type was predicted preoperatively based on characteristic endoscopic findings, in which an SMT-like mass was observed at the gastric fundus. The tumor was covered by nearly normal mucosa, but with an opening allowing for the passage of copious mucus discharge. A total gastrectomy with Roux-en-Y esophagojejunostomy was subsequently performed. Histopathology of the tumor revealed early-stage (lamina propria) mucinous adenocarcinoma.
Adenocarcinoma, Mucinous/*diagnosis/pathology/ultrasonography ; Adult ; Early Detection of Cancer ; Endoscopy, Digestive System ; Female ; Humans ; Mucous Membrane/pathology ; Neoplasm Staging ; Stomach Neoplasms/*diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

A gastric carcinoma with the endoscopic features resembling a submucosal tumor (SMT) is rare, and reportedly accounting for 0.1% to 0.63% of all resected gastric carcinomas in Japan. A diagnosis of a SMT-like gastric carcinoma is often difficult as the tumors are almost entirely covered with normal mucosa. Furthermore mucinous gastric adenocarcinoma is uncommon histologic subtype of gastric cancer. These tumors are detected mostly in an advanced stage and rarely in an early stage. Early mucinous gastric adenocarcinoma is characterized as an elevated lesion resembling SMT due to abundant mucin pools in the submucosa. Here we report one case of SMT-like mucinous gastric adenocarcinoma, diagnosed by the usual endoscopic biopsy and treated with surgery.
Adenocarcinoma, Mucinous/*diagnosis/pathology/ultrasonography ; Aged ; Diagnosis, Differential ; Gastric Mucosa/pathology ; Gastroscopy ; Humans ; Male ; Stomach Neoplasms/*diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

OBJECTIVETo investigate the feasibility, safety and efficacy of ultrasound-guided percutaneous microwave ablation (MWA) of splenic tumors.

METHODSSeven patients with 8 pathologically confirmed splenic tumors (including 2 metastases from the ovary and 4 from the lung, gastric adenocarcinoma, hepatocellular carcinoma, or rectal carcinoma; 1 hemangioma and 1 inflammatory pseudotumor) with sizes ranging from 1.3 to 6.2 cm (mean 3.1 ± 1.9 cm) were treated with MWA. A cooled shaft needle antenna was percutaneously inserted into the tumor under ultrasound guidance. A thermocouple was placed about 0.5 cm away from the tumor to monitor the temperature in real time during the ablation. The microwave emitting power was set at 50-60 W. The treatment efficacy was assessed by contrast-enhanced imaging at 1, 3 and 6 months following the procedure, and every 6 months thereafter.

RESULTSAll the tumors were completely ablated in a single session and no complications occurred. No local tumor progression was observed during a median follow up time of 13 months (4 to 92 months). The ablation zone, well defined on contrast-enhanced imaging, was gradually reduced with time. A new metastatic lesion was detected in the spleen at 11 months after the ablation in a ovarian carcinoma patient and was successfully treated by a second MWA. The post-ablation survival of the patients with splenic metastasis was 13 months (range 4 to 92 months). No complications other than fever and abdominal pain were observed in these patients.

CONCLUSIONUltrasound-guided percutaneous MWA is a safe and effective minimally-invasive technique for treatment of splenic tumors in selected patients.

Adenocarcinoma ; pathology ; Carcinoma, Hepatocellular ; pathology ; Catheter Ablation ; Contrast Media ; Female ; Humans ; Liver Neoplasms ; pathology ; Microwaves ; Minimally Invasive Surgical Procedures ; Ovarian Neoplasms ; pathology ; Splenic Neoplasms ; diagnostic imaging ; radiotherapy ; secondary ; Stomach Neoplasms ; pathology ; Treatment Outcome ; Ultrasonography