E. Melzer et H. Fidder, The natural course of upper gastrointestinal sub-mucosal tumors: an endoscopic ultrasound survey, ISR MED ASS, 2(6), 2000, pp. 430-432
Background: Differentiating between benign and malignant submucosal tumors
is difficult. Moreover, the natural course of benign-appearing SMTs is not
clearly elucidated.
Objectives: To evaluate the natural course of upper gastrointestinal SMTs b
y 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, inte
rnal 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 co
nverted to a non-homogenous tumor with an irregular outer margin. This lesi
on 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.