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World J Gastrointest Endosc. May 16, 2011; 3(5): 86-94
Published online May 16, 2011. doi: 10.4253/wjge.v3.i5.86
Endoscopic ultrasonography for gastric submucosal lesions
Ioannis S Papanikolaou, Konstantinos Triantafyllou, Anastasia Kourikou, Thomas Rösch
Ioannis S Papanikolaou, Anastasia Kourikou, Konstantinos Triantafyllou, Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, Medical School, University of Athens, Athens 12462, Greece
Thomas Rösch, Department of Interdisciplinary Endoscopy, University Hospital Hamburg-Eppendorf, Martinistrasse 52, Hamburg 20246, Germany
Author contributions: The authors contributed equally to the writing of the manuscript.
Correspondence to: Ioannis S Papanikolaou, MD, Hepatogastroenterology Unit, 2nd Department of Internal Medicine-Propaedeutic, Attikon University General Hospital, University of Athens, Rimini 1, Haidari, Athens 12462, Greece. ispapn@hotmail.com
Telephone: +30-210-5832090 Fax: +30-210-5326422
Received: December 24, 2010
Revised: May 3, 2011
Accepted: May 5, 2011
Published online: May 16, 2011
Abstract

Gastric submucosal tumors (SMTs) are a rather frequent finding, occurring in about 0.36% of routine upper GI-endoscopies. EUS has emerged as a reliable investigative procedure for evaluation of these lesions. Diagnostic Endoscopic ultrasonography (EUS) has the ability to differentiate intramural tumors from extraluminal compressions and can also show the layer of origin of gastric SMTs. Tumors can be further characterized by their layer of origin, echo pattern and margin. EUS-risk criteria of their malignant potential are presented, although the emergence of EUS-guided fne needle aspiration (EUS-FNA) has opened new indications for transmural tissue diagnosis and expanded the possibilities of EUS in SMTs of the stomach. Tissue diagnosis should address whether the SMT is a Gastrointestinal stromal tumour (GIST) or another tumor type and evaluate the malignant potential of a given GIST. However, there seems to be a lack of data on the optimal strategy in SMTs suspected to be GISTs with a negative EUS-FNA tissue diagnosis. The current management strategies, as well as open questions regarding their treatment are also presented.

Keywords: Endoscopic ultrasound; Gastric submucosal tumors; EUS-guided fne needle aspiration; Gastrointestinal stromal tumours