The Role of Endoscopic Ultrasonography Examination for Evaluation and Surveillance of Gastric Subepithelial Masses

Background: Endoscopic ultrasonography (EUS) has often been used to evaluate gastricsubepithelial masses (SEM) and their malignant potential. Information on theuse of EUS to survey small gastric SEM is limited.Methods: A total of 125 consecutive patients referred for evaluation of a suspected gastricSEM were evaluated by EUS from February 2002 to February 2008.Periodic surveillance using EUS or upper gastrointestinal endoscopy wasroutinely advised. Surgical treatment was considered if a malignant tumorwas suspected or symptomatic.Results: In the 125 patients, EUS found 23 (18.4%) cases of extraluminal compression,70 (56%) gastrointestinal stromal tumors (GISTs), 9 (7.2%) cases ofectopic pancreas, 5 (4.0%) mucosal tumors, 3 (2.4%) cases of varices, 2(1.6%) cysts, 2 (1.6%) lipomas, 1 (0.8%) mucosal polyp, 1 (0.8%) submucosaltumor, 6 (4.8%) patients with no abnormality, and 3 (2.4%) unidentifiedlesions. Surgery was performed in 15 patients, revealing GISTs in 10patients, and gastrointestinal autonomic nervous tumors (GANTs) in 2patients as well as other malignant lesions in 3 patients. The pathologicalfindings confirmed that 11 (73.3%) of 15 larger tumors (> 30 mm) wereaccurately diagnosed. Only 1 of 9 suspected GIST (mean initial tumor size13.4