[Is the invasive approach for all the upper gastrointestinal mesenchymal tumors necessary?].
OBJECTIVE
Mesenchymal tumors are the most frequent submucosal tumors in gastrointestinal trail. We reviewed the mesenchymal tumors which are confirmed by pathology to examine whether the invasive approach of all mesenchymal tumors is necessary.


METHODS
This study was performed on fifty-nine patients who has mesenchymal tumors confirmed by endoscopic or surgical resection from January 2000 to June 2004.


RESULTS
Mesenchymal tumors consisted of thirty-six gastrointestinal stromal tumors (GISTs), 20 leiomyomas and 3 schwannomas. All the esophageal tumors were leiomyoma (12/12, 100%). In stomach, there were 32 GISTs (76.2%), 7 leiomyomas (16.7%) and 3 schwannomas (7.1%). And there were 4 GISTs (80.0%) and 1 leiomyoma (20.0%) in duodenum. Tumors less than 1 cm in maximal diameter were leiomyoma or GISTs with very low risk of aggressive behavior. 56.1% of the tumors larger than 1 cm consisted of low, intermediate or high risk GISTs.


CONCLUSIONS
Biopsy must be considered according to its size and anatomic location of mesenchymal tumors. The invasive approach for every esophageal submucosal tumor is not necessary unless the size is very large, because most of them are benign in nature. However, the gastric submucosal tumor with more than 1 cm in diameter should be carefully and regularly followed up or biopsied because it cannot be assumed to be benign for any GIST more than 1 cm in size at the present time, safely.
Lee
Eun Ju
EJ
Department of Internal Medicine, Yeungnam University College of Medicine, Nam-gu, Daegu, Korea.
Kim
Tae Dong
TD
Oh
Heun Ah
HA
Lee
Hyeung Chul
HC
Kim
Jun Hwan
JH
Jang
Byung Ik
BI
Kim
Tae Nyeun
TN
Chung
Moon Kwan
MK
Bae
Young Kyeong
YK
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology*; D006801:Humans; D007889:Leiomyoma / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology; D041742:Upper Gastrointestinal Tract