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Create a Free AccountProcedures - Endoscopic ultrasound (EUS) - diagnostic
Successful diagnosis and endoscopic submucosal dissection of a gastric gastrointestinal stromal tumor originating from the submucosal layer
A 77-year-old man was introduced to our institution because of a slow-growing gastric subepithelial tumor (SET). Esophagogastroduodenoscopy revealed an SET approximately 2 cm in size in the fundus of the stomach, which was covered with normal smooth mucosa (Fig. 1A). EUS using a 20-MHz miniature probe (UM-3R; Olympus, Tokyo, Japan) showed a uniform hypoechoic lesion, 21.4 mm in size, in the third layer of the stomach wall (Fig. 1B). The hypoechoic fourth layer was intact and could be observed below the tumor (Fig. 1C).Endoscopic submucosal dissection for Barrett’s-associated adenocarcinoma in a patient with decompensated cirrhosis and esophageal varices
Presently, endoscopic resection is the preferred treatment of choice for patients with Barrett’s dysplasia, especially high-grade dysplasia and even early esophageal adenocarcinoma.1 However, among the various endoscopic resection techniques, endoscopic submucosal dissection (ESD) may carry a higher risk of adverse events in patients with cirrhosis because of the low platelet count, coagulopathy, and presence of esophageal varices.2,3 To date, only small case series of esophageal ESDs, especially for squamous cell carcinoma, have been reported from Asia in patients with cirrhosis, but the included patients were well compensated, with platelet counts >50 k/μL.Endoscopic submucosal dissection of an esophageal granular cell tumor
Granular cell tumors (GCTs) are a rare entity that can affect the whole human body. Concerning the esophagus, in 2% to 4% of cases, a malignant potential has been reported, which increases with size. That is why resection should be pursued, especially in lesions >1 cm. Because most GCTs show a submucosal manifestation, endoscopic submucosal dissection (ESD) is a favorable anatomically convincing method because it involves circumferential incision of the mucosa surrounding the tumor, followed by dissection of the submucosa.
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