What Kind of Gastric Tumor Is This?

Oscar M. Crespin, MD; Ali Kagan Coskun, MD; Brant K. Oelschlager, MD; Carlos A. Pellegrini, MD

Disclosures

January 15, 2014

Gastrointestinal Tract Tumors

Submucosal tumors are a relatively uncommon tumor type in the gastrointestinal (GI) tract. They are most commonly found in the stomach, although they can present anywhere within the GI system. A gastrointestinal submucosal tumor (GIST) is the most common submucosal tumor of the stomach, although several other types of submucosal tumors can be frequently mistaken for GISTs.

Gastric leiomyoma (GLM) is a rare gastric tumor. Unlike GISTs, GLMs are benign, with no propensity for metastatic or extramural growth.

Other types of submucosal tumors include leiomyosarcoma, malignant melanoma, schwannoma, malignant peripheral nerve sheath tumor, fibromatosis (desmoid tumor), inflammatory myofibroblastic tumor, and metaplastic ("sarcomatoid") carcinoma.

Unlike for mucosal tumors, an endoscopic biopsy using standard biopsy forceps usually cannot obtain adequate tissue for accurate diagnosis of submucosal tumors. As a result, most large gastric submucosal masses require surgical resection to rule out the possibility of malignancy.

Small submucosal masses not diagnosed by endoscopic biopsy can require either surgical resection or follow-up imaging. However, modern imaging and endoscopic needle core biopsy, along with immunohistochemistry, often allow for preoperative diagnosis, which in turn allows for more surgical options.[1]

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