[Endoscopic ultrasonography in the diagnosis of submucosal tumors of the upper digestive tract]

Abstract

Endoscopic Ultrasonography (EUS) was performed in 520 patients. In 78 subjects, it was indicated because of endoscopic suspicion of submucosal tumors (SMT), later confirmed in 67 patients. Thirty seven patients were symptomatic; in 22 patients the finding was incidental and in 7 the indication was unknown. According to the ecogenic pattern of the lesions found and the layer of the tumor origin the following were diagnosed: 14 leiomyomas, 1 lipoma, 3 granular cell tumors and 2 without precise diagnosis in the esophagus. Thirty leiomyomas, 6 leiomyosarcomas, 4 lipomas, 4 ectopic pancreas and 2 without precise diagnosis in the stomach. One leiomyoma in the duodenum. From the 11 SMT initially suspected by endoscopy which showed an integrity of the wall there were 10 extrinsic compressions and 1 without pathological findings. To date, surgery was performed on 22 patients with SMT complicated with ulcer and/or hemorrhage and on those larger than 3 cm with an ecogenic pattern, suspected of malignancy. Thirteen gastric leiomyomas, 2 gastric lipomas and 1 ectopic pancreas, with a 100% correlation in the postresection histological studies, 2 Abricosoff tumors of the esophagus, 2 leiomyosarcomas with 100% correlation and a giant lipoma of the esophagus which resulted in a liposarcoma, and 1 leiomyoma which resulted in a leiomyosarcoma were found. According to these results 90% diagnostic specificity and 100% sensitivity make this imaging technique the ideal method to evaluate these lesions and one of the main indications together with the staging of gastrointestinal tumors.