Clinical course of subepithelial lesions detected on upper gastrointestinal endoscopy.
OBJECTIVE
To evaluate the natural history of subepithelial lesions.


METHODS
We reviewed the medical records of 104159 patients who underwent upper gastrointestinal endoscopy at the Center for Health Promotion of Samsung Medical Center between 1996 and 2003. Subepithelial lesions were detected in 795 patients (0.76%); 252 patients were followed using upper gastrointestinal endoscopy for 82.5 +/- 29.2 mo (range, 12-160 mo; median, 84 mo; 1st quartile, 60 mo; 3rd quartile, 105 mo). The median interval of follow-up endoscopy was 12 mo (range, 6-105 mo; 1st quartile, 12 mo; 3rd quartile, 24 mo).


RESULTS
The mean patient age was 53 years (range, 22-80 years), and the male-to-female ratio was 2.36:1 (177/75). The lesion size at initial measurement averaged 8.9 mm (range, 2-25 mm; median, 8 mm; 1st quartile, 5 mm; 3rd quartile, 10 mm). Of the 252 lesions, 244 (96.8%) were unchanged and 8 (3.2%) were significantly increased in size (from 12.9 +/- 6.0 to 21.2 +/- 12.2 mm) after a mean interval of 59.1 +/- 27.5 mo (range, 12-86 mo). Surgical resection of lesions was performed when the lesions were > or = 3 cm in diameter. Two lesions were diagnosed as gastrointestinal stromal tumors with an intermediate or high risk of malignancy and one lesion was classified as a schwannoma.


CONCLUSIONS
Most small subepithelial lesions do not change as shown by endoscopic examination, and regular follow-up with endoscopy may be considered in small, subepithelial lesions, especially lesions < 1 cm in size.
Lim
Yeun Jung
YJ
Center for Health Promotion, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea.
Son
Hee Jung
HJ
Lee
Jong-Soo
JS
Byun
Young Hye
YH
Suh
Hyun Joo
HJ
Rhee
Pool Lyul
PL
Kim
Jae J
JJ
Rhee
Jong Chul
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016099:Endoscopy, Gastrointestinal; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012189:Retrospective Studies; D041742:Upper Gastrointestinal Tract / Q000473:pathology*; D055815:Young Adult