Subepithelial tumors (SETs) include widely malignant tumors such as GI stromal tumors,
malignant lymphomas, carcinoid tumors, gastric cancers similar to SETs, and benign
tumors such as leiomyomas, aberrant pancreas, and lipomas. Currently, minimally invasive
local resection techniques such as hybrid natural orifice transluminal endoscopic
surgery (NOTES), which consists of endoscopic full-thickness gastric resection, have
been developed for the treatment of GI stromal tumors.
1
However, there is no consensus regarding the optimal strategy for the tissue diagnosis
of SETs before determining the plans for further management such as surgical resection
or observation. SET differentiation is essentially important, because different types
of lesions may need different management, prognoses, and therapeutic options. EUS
morphologic features alone have limited specificity for the diverse subtypes of SETs,
and EUS cannot differentiate between a benign or malignant origin. Recently, several
diagnostic methods have been proposed for the tissue diagnosis of SETs. EUS-guided
FNA (EUS-FNA) biopsy has been introduced as an easy, safe, and valuable method for
obtaining tissue samples for the accurate diagnosis of GI SETs.
2
,
3
,
4
,
5
,
6
,
7
In addition, there are some reports about the use of combined strip biopsy and bite
biopsy with biopsy forceps
8
,
9
and the unroofing technique by using an electrocautery snare for collecting tissue
samples from SETs.
10
However, these methods have some limitations in accurate diagnosis and safety.
4
,
7
,
10
Abbreviations:
ESD (endoscopic submucosal dissection), NOTES (natural orifice transluminal endoscopic surgery), SEMF (submucosal endoscopy with a mucosal flap method), SET (subepithelial tumor), SINK (single-incision needle-knife.)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 28, 2012
Accepted:
August 7,
2012
Received:
May 10,
2012
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
© 2013 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
