The natural course of upper gastrointestinal submucosal tumors: an endoscopic ultrasound survey.
BACKGROUND
Differentiating between benign and malignant submucosal tumors is difficult. Moreover, the natural course of benign-appearing SMTs is not clearly elucidated.


OBJECTIVE
To evaluate the natural course of upper gastrointestinal SMTs by endoscopic endosonography.


METHODS
We followed 25 consecutive patients with small (< 40 mm) SMTs for a mean period of 19 months. Evaluation included maximal tumor diameter, internal echo pattern, and outer margin of lesions.


RESULTS
Follow-up revealed no change in echo features in 24 of 25 patients (96%). In only one patient a homogenous hypoechoic smooth margin lesion converted to a non-homogenous tumor with an irregular outer margin. This lesion also increased in size from 30 to 38 mm. On surgical removal this tumor was found to be a stromal tumor with high malignant potential.


CONCLUSIONS
Most small SMTs do not change during a period of 19 months and a conservative policy of surveillance is warranted.
Melzer
E
E
Department of Gastroenterology, Sheba Medical Center, Tel-Hashomer, Israel.
Fidder
H
H
D000368:Aged; D000369:Aged, 80 and over; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging*