• cecal neoplasm
• endosonography
• erectile dysfunction
• penile prosthesis
• subepithelial lesion

• UL1 TR001863 NCATS NIH HHS

• colon subepithelial tumor
• endoscopic ultrasound
• histological finding

• Deep learning
• EUS
• Submucosal tumors

• Endoscopic treatment
• Endoscopic ultrasound (EUS)
• Submucosal tumor (SMT)

• Humans
• Retrospective Studies
• Upper Gastrointestinal Tract
• Endosonography
• Endoscopy
• Neoplasms

• Benign tumors
• Case report
• Esophagus
• Leiomyoma
• Literature review

• Artificial intelligence
• Deep learning
• Endosonography
• Gastrointestinal stromal tumors
• Leiomyoma

• Endosonography
• Gastrointestinal Stromal Tumors/diagnostic imaging
• Humans
• Neural Networks, Computer
• Reproducibility of Results

• 5-2019-B0001-00118 Po-Ca Networking Groups
• 2019-0-01906 Institute for Information & Communications Technology Promotion
• 2020R1A2C1009744 National Research Foundation
• NRF-2018M3A9E8021507 Bio & Medical Technology Development Program

• Endoscopic ultrasound
• endoscopic resection
• subepithelial lesion

• Bypass
• Endoscopy
• GIST
• Leiomyoma
• POEM
• STER
• Sleeve gastrectomy
• Submucosal tumors

To assess the role of endoscopic ultrasound (EUS) in the diagnosis of upper gastrointestinal subepithelial lesions (SELs) and to investigate EUS combined with a grayscale histogram analysis for the differentiation of leiomyomas and gastrointestinal stromal tumors (GISTs).

A retrospective study of 709 patients with upper gastrointestinal SELs was conducted by EUS before endoscopic resection. The EUS findings of SELs and pathological results after endoscopic resection were compared. The EUS images of SELs, particularly, leiomyoma and GIST, were further analyzed via a grayscale histogram to differentiate between the two tumors.

Of the 709 patients, 47 cases were pathologically undetermined. The diagnostic consistency of EUS with endoscopic resection was 88.2% (584/662), including 185 muscularis mucosa, 61 submucosa, and 338 muscularis propria, respectively. The diagnostic consistency of EUS with pathology was 80.1% (530/662). The gray value of GISTs was significantly higher than that of leiomyomas (58.9 ± 8.3 vs. 39.5 ± 5.9, t = 57.0, P < 0.0001). The standard deviation of leiomyomas was significantly lower than that of GISTs (20.6 ± 7.0 vs. 39.8 ± 9.3, t = 23.7, P < 0.0001). The grayscale histogram analysis of GISTs showed higher echo ultrasound, and the echo of leiomyoma was more uniform.

EUS is the preferred procedure for the evaluation of upper gastrointestinal SELs. EUS combined with a grayscale histogram analysis is an effective method for the differentiation of leiomyomas and GISTs.

• Endoscopic ultrasound-guided fine-needle aspiration
• Gastrointestinal stromal tumor
• Hypoechoic lesions
• Stomach
• Surveillance strategy
• Unroofing biopsy

• Per-oral Endoscopic Tumor resection (POET)
• submucosal tumor
• submucosal tunneling tumor resection (STER)

• Adult
• Aged
• Aged, 80 and over
• Cardia
• Endoscopic Mucosal Resection
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/surgery
• Female
• Gastrointestinal Stromal Tumors/pathology
• Gastrointestinal Stromal Tumors/surgery
• Hospitalization
• Humans
• Leiomyoma/pathology
• Leiomyoma/surgery
• Male
• Middle Aged
• Natural Orifice Endoscopic Surgery
• Neurilemmoma/pathology
• Neurilemmoma/surgery
• Operative Time
• Retrospective Studies
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery
• Treatment Outcome

The origin and characteristics of most submucosal tumors (SMTs) cannot easily be confirmed by gastrointestinal endoscopy or other radiological examinations. Excluding GISTs, for those other gastric SMTs, most of which are deemed benign, the necessity and timing of intervention has been ignored. Thus, the malignancy of gastric SMTs still remains unknown. In order to summarize the malignancy of these gastric SMTs, we reviewed literatures and analyzed cases of gastric SMTs including heterotopic pancreas, leiomyoma, schwannoma, glomus tumor, hemangioendothelioma, granular cell tumor (GCT), lipoma, hemangiopericytoma, lymphangioma and neurofibroma. In these literatures, there are cases of malignancy among heterotopic pancreas, leiomyoma, schwannoma, glomus tumor, hemangioendothelioma and GCT. As a result, it suggests that although most of gastric SMTs are considered benign, there are still possibilities of malignancy, which requires our attention, even active intervention and long-term follow-up.

• Gastric submucosal tumor (gastric SMT)
• malignancy

Endoscopic ultrasonography (EUS) is the most efficient imaging modality for gastric subepithelial tumors (SETs). However, abdominopelvic computed tomography (APCT) has other advantages in evaluating the characteristics, local extension, or invasion of SETs to adjacent organs. This study aimed to compare the diagnostic ability of EUS and APCT based on surgical histopathology results.

We retrospectively reviewed data from 53 patients who underwent both EUS and APCT before laparoscopic wedge resection for gastric SETs from January 2010 to December 2017 at a single institution. On the basis of histopathology results, we assessed the diagnostic ability of the 2 tests.

The overall accuracy of EUS and APCT was 64.2% and 50.9%, respectively. In particular, the accuracy of EUS vs. APCT for the diagnosis of gastrointestinal stromal tumors (GISTs), leiomyomas, and ectopic pancreas was 83.9% vs. 74.2%, 37.5% vs. 0.0%, and 57.1% vs. 14.3%, respectively. Most of the incorrect diagnoses with EUS involved hypoechoic lesions originating in the fourth echolayer, with the most common misdiagnosed lesions being GISTs mistaken for leiomyomas and vice versa.

APCT showed a lower overall accuracy than EUS; however, APCT remains a useful modality for malignant/potentially malignant gastric SETs.

• Abdominopelvic computed tomography
• Diagnosis
• Endoscopic ultrasonography
• Subepithelial tumor

Differentiating gastrointestinal stromal tumor (GIST) from other submucosal tumors (SMTs) is important in diagnosing SMT. GIST is an immunohistological diagnosis that cannot be made from images alone. Tissue sampling of tumor sites is thus becoming increasingly important. In this study, the utility and associated complications of mucosal cutting biopsy (MCB) for gastric SMTs were investigated.

This was a case series study. The subjects were patients aged ≥20 years old in whom an SMT was seen on esophagogastroduodenography and who underwent MCB between January 2012 and December 2016. Patient information, endoscopy findings, gastric SMT size, pathological diagnosis, and other information were gathered from medical records. The SMT size was the maximum diameter that could be visualized on EUS. The pathological diagnosis was made with hematoxylin-eosin staining, with immunostaining added to diagnose GIST. The endpoint was the histopathological diagnostic yield. Risk assessment using the Miettinen classification and modified Fletcher classification was also done for GISTs treated with surgery.

The mean tumor diameter was 15.4 mm. The tumor diameter was ≥20 mm in seven patients and <20 mm in 23 patients. The tissue-acquiring rate was 93.3%. A histological diagnosis could not be made in two patients. The only complication was that bleeding required endoscopic hemostasis during the procedure in one patient, but no subsequent bleeding or no postoperative bleeding was seen.

MCB is an appropriate and safe procedure in the diagnosis of gastric SMTs. Many hospitals will be able to perform MCB if they have the environment, including skills and equipment, to perform endoscopic submucosal dissection.

• Endosonography
• Gastrointestinal stromal tumors
• Prognosis
• Stomach neoplasms
• Tomography, x-ray computed

Subepithelial lesions (SELs) of the upper part of the digestive tract are rare, and it can be difficult to characterize them. Recently, contrast-enhanced endosonography (EUS) and elastometry have been reported as useful adjuncts to EUS and EUS-guided fine needle aspiration (EUS-FNA) in cases of pancreatic mass and lymph node involvement. The aim of this retrospective analysis was to evaluate whether contrast-enhanced EUS can discriminate benign submucosal lesions from malignant ones. We describe our retrospective experience using the contrast agent SonoVue^® (Bracco Imaging, Milan, Italy) in an attempt to increase the diagnostic yield.

Between May 2011 and September 2014, 14 patients (5 men, 9 women; median age 64 years, range 31–80 years) with SELs of the stomach or esophagus underwent EUS with SonoVue^® (low mechanical index). There were 3 esophageal lesions and 11 gastric lesions. Mean size of the lesions was 30 mm (range 11–50 mm). They were discovered after anemia (n = 5), dysphagia (n = 1), and pain (n = 4) and during follow-up for resected gastrointestinal stromal tumors (GISTs) (n = 1) and a standard upper gastrointestinal endoscopy (n = 3). On endoscopic sonograms, 10 of these lesions were hypoechoic and located in the fourth layer (muscularis), and 4 were in the second or third layer (mucosa and submucosa). Contrast enhancement was assessed in the early phase (after several seconds) and late phase (>30 seconds); a final diagnosis was made based on the findings of EUS-FNA using a 19-gauge ProCore (Cook Medical, Bloomington, IN) (n = 9) or 22-gauge FNA system (Cook Medical) (n = 1), the resected specimen (n = 3), or deep biopsy (n = 1). Different immunostaining was used in the pathologic studies (RNA was analyzed later using the C-kit, CD-117, CD-34, desmin, DOG-1, α-smooth actin, caldesmon, PS-100, and Ki-67 antibodies).

Final diagnoses were leiomyoma (n = 4), GIST (n = 5), schwannoma (n = 1), inflammatory tumor of Helvig (n = 1), pancreas rest (n = 2), and fibrosis (n = 1). No complications occurred. All 5 GISTs showed enhancement in the early and late phases, whereas the 8 remaining lesions did not show any enhancement. Only 1 leiomyoma showed heterogeneous enhancement.

The monocentric and retrospective study design and small number of patients.

In cases of SELs of the stomach or esophagus, SonoVue^® could be a complementary tool to endosonography to differentiate GISTs (early and clear enhancement) from other SELs (few or no enhancement), such as leiomyomas or pancreatic rest. These results are similar to those of the few, small studies published on this topic, but more studies with a larger number of patients are needed to confirm these findings.

• Contrast enhancement
• diagnosis
• endosonography
• esophagus
• subepithelial lesions of the stomach

To image stomach wall blood vessels and tissue, layer-by-layer.

We built up the acoustic resolution photoacoustic microscopy (AR-PAM) system for imaging layered tissues, such as the stomach wall. A tunable dye laser system was coupled to a fiber bundle. The fibers of the bundle were placed in nine directions with an incident angle of 45° around a high-frequency ultrasound transducer attached to the acoustic lens. This structure formed a dark field on the tissue surface under the acoustic lens and the nine light beams from the fibers to be combined near the focal point of the acoustic lens. The sample piece was cut from a part of the porcine stomach into a petri dish. In order to realize photoacoustic depth imaging of tumor, we designed a tumor model based on indocyanine green (ICG) dye. The ICG solution (concentration of 129 μM/mL) was mixed into molten gel, and then a gel mixture of ICG (concentration of 12.9 μM/mL) was injected into the stomach submucosa. The injection quantity was controlled by 0.1 mL to make a small tumor model.

An acoustic resolution photoacoustic microscopy based on fiber illumination was established and an axial resolution of 25 μm and a lateral resolution of 50 μm in its focal zone range of 500 μm has been accomplished. We tuned the laser wavelength to 600 nm. The photoacoustic probe was driven to do B-scan imaging in tissue thickness of 200 μm. The photoacoustic micro-image of mucosa and submucosa of the tissue have been obtained and compared with a pathological photograph of the tissue stained by hematoxylin-eosin staining. We have observed more detailed internal structure of the tissue. We also utilized this photoacoustic microscopy to image blood vessels inside the submucosa. High contrast imaging of the submucosa tumor model was obtained using ICG dye.

This AR-PAM is able to image layer-by-layer construction and some blood vessels under mucosa in the stomach wall without any contrast agents.

• Photoacoustic imaging
• Stomach
• Layered tissue
• Acoustic resolution
• Fiber

• Animals
• Coloring Agents/chemistry
• Disease Models, Animal
• Equipment Design
• Humans
• Image Enhancement/methods
• Indocyanine Green/chemistry
• Lasers, Dye
• Microscopy, Acoustic/instrumentation
• Microscopy, Acoustic/methods
• Microvessels/diagnostic imaging
• Stomach/blood supply
• Stomach/diagnostic imaging
• Stomach Neoplasms/diagnostic imaging
• Sus scrofa

In a tertiary center setting we aimed to study the diagnostic accuracy and clinical impact of EUS-guided biopsy sampling (EUS-FNB) with a reverse bevel needle compared with that of fine needle aspiration (EUS-FNA) in the work-up of subepithelial lesions (SEL).

All patients presenting with SELs referred for EUS-guided sampling were prospectively included in 2012–2015. After randomization of the first pass modality, dual sampling with both EUS-FNB and EUS-FNA was performed in each lesion. Outcome measures in an intention-to-diagnose analysis were the diagnostic accuracy, technical failures, and adverse events. The clinical impact was measured as the performance of additional diagnostic procedures post-EUS and the rate of unwarranted resections compared with a reference cohort of SELs sampled in the same institution 2006–2011.

In 70 dual sampling procedures of unique lesions (size: 6–220 mm) the diagnostic sensitivity for malignancy and the overall accuracy of EUS-FNB was superior to EUS-FNA compared head-to-head (90 vs 52%, and 83 vs 49%, both p < 0.001). The adverse event rate of EUS-FNB was low (1.2%). EUS-FNB in 2012–2015 had a positive clinical impact in comparison with the reference cohort demonstrated by less cases referred for an additional diagnostic procedure, 12/83 (14%) vs 39/73 (53%), p < 0.001, and fewer unwarranted resections in cases subjected to surgery, 3/48 (6%) vs 12/35 (34%), p = 0.001.

EUS-FNB with a reverse bevel needle is safe and superior to EUS-FNA in providing a conclusive diagnosis of subepithelial lesions. This biopsy sampling approach facilitates a rational clinical management and accurate treatment.

The online version of this article (doi:10.1007/s00464-017-5808-2) contains supplementary material, which is available to authorized users.

• Clinical impact
• Endoscopic ultrasound
• Fine needle biopsy
• Gastrointestinal stromal tumor
• Leiomyoma
• Subepithelial lesion

• Gastric submucosal tumor; Endoscopic submucosal dissection; Endoscopic full-thickness resection; Muscularis propria

• USCE
• UmTDD
• acoustic sensing
• capsule endoscopy
• endoscopy
• gastrointestinal
• targeted drug delivery
• theranostics
• ultrasonic drug delivery
• ultrasound

• Capsule Endoscopy
• Diagnosis, Computer-Assisted
• Humans
• Telemetry
• Theranostic Nanomedicine
• Ultrasonics

• Benign tumour
• Oesophageal leiomyoma
• Resection

• Endoscopic ultrasonography
• Esophagogastroduodenoscopy
• Multi-detector computed tomography
• Stomach neoplasms
• Subepithelial tumors

• Endoscopy, Digestive System
• Endosonography
• Female
• Humans
• Male
• Middle Aged
• Predictive Value of Tests
• Retrospective Studies
• Sensitivity and Specificity
• Stomach Neoplasms/diagnostic imaging
• Tomography, X-Ray Computed

• Gastrointestinal diseases
• Perineal ultrasound
• Rectal endosonography
• Ultrasound

• Colon/diagnostic imaging
• Colonic Diseases/diagnostic imaging
• Contrast Media/administration & dosage
• Elasticity Imaging Techniques
• Endosonography
• Humans
• Predictive Value of Tests
• Prognosis
• Rectal Diseases/diagnostic imaging
• Rectum/diagnostic imaging
• Ultrasonography/methods
• Ultrasonography, Doppler

Gastric glomus tumors (GGTs) are unusual benign, subepithelial, mesenchymal neoplasms of modified smooth muscle cells representing a neoplastic counterpart of glomus bodies. A 38-year-old woman was admitted to our clinic presenting morbid obesity. Routine preoperative evaluations, such as laboratory analysis, abdominal ultrasonography, and upper gastrointestinal endoscopy, were performed. She underwent a classical laparoscopic sleeve gastrectomy (LSG). The postoperative course was uneventful and she was discharged for outpatient control. Her histopathology report revealed a GGT 0.8 cm in diameter. No further treatment was done and she had lost 28 kg at the postoperative sixth month. Here, we present the case of GGT, which was diagnosed incidentally after LSG.

• Bariatric Surgery
• Gastrectomy
• Glomus Tumor
• Incidental Findings
• Stomach

• Efficacy
• Endoscopic
• Submucosal tumor
• Ultrasonography

• Adult
• Aged
• Choristoma/diagnostic imaging
• Choristoma/pathology
• Choristoma/surgery
• Disease-Free Survival
• Duodenal Neoplasms/diagnostic imaging
• Duodenal Neoplasms/pathology
• Duodenal Neoplasms/surgery
• Endoscopic Mucosal Resection/methods
• Endoscopy
• Endosonography
• Esophageal Neoplasms/diagnostic imaging
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/surgery
• Feasibility Studies
• Female
• Follow-Up Studies
• Gastrointestinal Stromal Tumors/diagnostic imaging
• Gastrointestinal Stromal Tumors/pathology
• Gastrointestinal Stromal Tumors/surgery
• Granulosa Cell Tumor/diagnostic imaging
• Granulosa Cell Tumor/pathology
• Granulosa Cell Tumor/surgery
• Humans
• Leiomyoma/diagnostic imaging
• Leiomyoma/pathology
• Leiomyoma/surgery
• Lipoma/diagnostic imaging
• Lipoma/pathology
• Lipoma/surgery
• Male
• Middle Aged
• Mucous Membrane/diagnostic imaging
• Mucous Membrane/pathology
• Mucous Membrane/surgery
• Muscle, Smooth
• Neuroendocrine Tumors/diagnostic imaging
• Neuroendocrine Tumors/pathology
• Neuroendocrine Tumors/surgery
• Pancreas
• Postoperative Period
• Preoperative Care
• Prospective Studies
• Stomach Neoplasms/diagnostic imaging
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery
• Treatment Outcome
• Tumor Burden
• Young Adult

Surgical enucleation is the treatment of choice for esophageal submucosal tumors (SMTs) with symptomatic, larger, or ill-defined lesions. The enucleation of SMTs has traditionally been performed via thoracotomy. However, minimally invasive approaches have recently been introduced and successfully applied. In this study, we present our experiences with the thoracotomic and thoracoscopic approaches to treating SMTs.

We retrospectively reviewed 53 patients with SMTs who underwent surgical enucleation between August 1996 and July 2013. Demographic and clinical features, tumor-related factors, the surgical approach, and outcomes were analyzed.

There were 36 males (67.9%) and 17 females (32.1%); the mean age was 49.2±11.8 years (range, 16 to 79 years). Histology revealed leiomyoma in 51 patients, a gastrointestinal stromal tumor in one patient, and schwannoma in one patient. Eighteen patients (34.0%) were symptomatic. Fourteen patients underwent a planned thoracotomic enucleation. Of the 39 patients for whom a thoracoscopic approach was planned, six patients required conversion to thoracotomy because of overly small tumors or poor visualization in five patients and accidental mucosal injury in one patient. No mortality or major postoperative complications occurred. Compared to thoracotomy, the thoracoscopic approach had a slightly shorter operation time, but this difference was not statistically significant (120.0±45.6 minutes vs. 161.5±71.1 minutes, p=0.08). A significant difference was found in the length of the hospital stay (9.0±3.2 days vs. 16.5±5.4 days, p<0.001).

The thoracoscopic enucleation of submucosal esophageal tumors is safe and is associated with a shorter length of hospital stay compared to thoracotomic approaches.

• Enucleation
• Esophagus, surgery
• Submucosal tumors of the esophagus
• Thoracoscopy

• Adult
• Aged
• Angioplasty/methods
• Feasibility Studies
• Female
• Gastric Mucosa/pathology
• Gastrointestinal Stromal Tumors/pathology
• Gastrointestinal Stromal Tumors/surgery
• Gastroscopy/methods
• Humans
• Leiomyoma/pathology
• Leiomyoma/surgery
• Male
• Microsurgery/methods
• Middle Aged
• Neoplasm Recurrence, Local
• Neurilemmoma/pathology
• Neurilemmoma/surgery
• Operative Time
• Retrospective Studies
• Stomach Neoplasms/pathology
• Stomach Neoplasms/surgery
• Treatment Outcome

• EUS-FNA
• Rosai-Dorfman disease
• gastrointestinal tract

• Deglutition Disorders/etiology
• Deglutition Disorders/pathology
• Diagnosis, Differential
• Eosinophilia/diagnosis
• Eosinophilia/pathology
• Esophageal Neoplasms/complications
• Esophageal Neoplasms/diagnosis
• Esophageal Neoplasms/pathology
• Esophageal Neoplasms/surgery
• Esophagus/pathology
• Esophagus/surgery
• Humans
• Leiomyoma/complications
• Leiomyoma/diagnosis
• Leiomyoma/pathology
• Leiomyoma/surgery
• Male
• Young Adult

• endoscopic ultrasonography (EUS)
• gastrointestinal stromal tumor (GIST)
• high-risk feature
• minimal invasive surgery
• submucosal tumor (SMT)

Endoscopic submucosal dissection (ESD) is a well-established method for the treatment of gastrointestinal epithelial tumors. However, the treatment of gastric subepithelial tumors (SETs) that originate from the muscularis propria layer still depends primarily on surgical techniques. We evaluated the appropriate indications for ESD in the treatment of SETs that originate from the muscularis propria layer.

Thirty-five patients with gastric SETs that originate from the muscularis propria layer who underwent ESD were enrolled, and the charts were retrospectively reviewed to investigate the parameters predictive complete resection and complications.

The mean age of the patients was 54.15 ± 9.3 years, and the male/female ratio was 2:3. Twenty-eight of the 35 SETs (85.7 %) were movable, and 15 (45.7 %) had a positive rolling sign. The most frequent location of the SETs was high body (n = 14). The most common pathological diagnoses were leiomyoma (60 %) and gastrointestinal stromal tumor (28.6 %). The complete resection rate was 74.3 %. A positive rolling sign (p = 0.022) and small tumor size (≤20 mm; p = 0.038) were significantly associated with complete resection. Two patients (6.1 %) developed perforations that required surgical treatment; their SMTs were neurogenic tumors with fixed lesion. Tumor mobility was significantly associated with perforation (p = 0.017).

The ESD method appears to be relatively safe for use in the complete resection of SETs that originate from the muscularis propria layer. Small tumor size (≤20 mm) and a positive rolling sign are appropriate indications for ESD.

• Benign esophageal tumor
• enucleation
• esophageal leiomyoma

Subepithelial tumors (SETs) are often incidentally found during endoscopic examinations. Endoscopic ultrasonography (EUS) is a good method for differential diagnosis of SETs, but a definite diagnosis cannot be made based on EUS features alone in some cases. Periodic follow-up examinations by endoscopy and EUS remains the recommended management strategy, which involves issues related to patient compliance, cost-effectiveness, and the risk associated with repeated endoscopic procedures and delayed diagnosis of malignancy. Endoscopic resection of the SETs is another technique to treat them as well as to obtain tissue specimens for accurate histologic diagnosis. Herein, a various endoscopic techniques ranging from simple snare resection to endoscopic submucosal tunnel dissection for the management of SETs will be reviewed.

• Endoscopic resection
• Neoplasms
• Subepithelial

The preoperative prediction of malignant potential in patients with gastric submucosal tumors (SMTs) plays an important role in decisions regarding their surgical management.

We evaluated the predictors of malignant gastric SMTs in 314 patients with gastric SMTs who underwent surgery in Chonnam National University Hospital.

The malignant SMTs were significantly associated with age (odds ratio [OR], 1.067; 95% confidence interval [CI], 1.042 to 1.091; P < 0.0001), presence of central ulceration (OR, 2.690; 95% CI, 1.224 to 5.909; P = 0.014), and tumor size (OR, 1.791; 95% CI, 1.483 to 2.164; P < 0.0001). Receiver operating characteristic curve analysis showed that tumor size was a good predictor of malignant potential. The most relevant predictor of malignant gastric SMT was tumor size with cut-offs of 4.05 and 6.40 cm.

Our findings indicated that age, central ulceration, and tumor size were significant preoperative predictors of malignant SMTs. We suggest that 4 cm be selected as a threshold value for malignant gastric SMTs. In patients with a gastric SMT larger than 4 cm with ulceration, wide resection of the full thickness of the gastric wall or gastrectomy with adequate margins should be performed because of its malignant potential.

• Malignant factor
• Preoperative predictor
• Stomach neoplasms
• Submucosal tumor

• Aged
• Confidence Intervals
• Disease Progression
• Endosonography
• Female
• Gastrointestinal Stromal Tumors/diagnostic imaging
• Gastrointestinal Stromal Tumors/pathology
• Gastroscopy
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Predictive Value of Tests
• Retrospective Studies
• Stomach Neoplasms/diagnostic imaging
• Stomach Neoplasms/pathology
• Tumor Burden

Gastric glomus tumors are extremely rare, and presurgical confirmation is often impossible. The identification of clinical and radiologic characteristics of this tumor type is important for preoperative diagnosis and treatment planning.

In this study, we analyzed 10 cases of gastric glomus tumors resected at a single institute over 9 years.

Eight of the patients were men and 2 were women, with a mean age of 49 years. Five patients presented with abdominal discomfort or pain, 1 presented with anemia, and the remaining 4 cases were found incidentally during endoscopic examinations. The most common location of the tumor was the antrum (n=7), followed by the low (n=2) and high body (n=1). Although the endoscopic ultrasonography findings were variable, contrast-enhanced computed tomography generally showed a strong homogeneous enhancement. The resected tumors were well-demarcated solid masses with sizes ranging from 1.0 to 3.6 cm. Microscopically, the masses were composed of abundant vascular channels with clusters of uniform and round glomus cells. There was no evidence of recurrence after complete surgical resection.

Gastric glomus tumors are unusual, distinct lesions that should be considered in the differential diagnosis of a gastric submucosal mass. Unlike their deep soft tissue counterparts, most glomus tumors in the stomach are benign.

• Endoscopy
• Glomus tumor
• Pathology
• Radiology
• Stomach