Most subepithelial tumors of the stomach are found incidentally at upper endoscopy and may arise from any of the layers of the stomach. Subepithelial tumors are evaluated for size, consistency, color, and shape by conventional endoscopy. The most common of these is the gastrointestinal stromal tumor (GIST), which is potentially malignant. GISTs are usually firm and immobile. Carcinoid tumor appears as slightly yellow, sessile, or semipedunculated lesions with normal-appearing overlying mucosa. Lipomas are often yellowish and compress like a pillow with a forceps. Pancreatic rests are often antral and may have a central umbilication. If the cause of the lesion is not evident at conventional endoscopy, it should be evaluated with endoscopic ultrasonography (EUS), which can determine the size and the layer of origin. Histology is the confirmative method to differentiate between the different types of subepithelial lesions.
This is a preview of subscription content, log in to check access.
Korean Society of Gastrointestinal Endoscopy. Atlas of Gastrointestinal Endoscopy. Seoul: Medbook; 2011.Google Scholar
Korean Society of Gastrointestinal Endoscopy EUS study group. Textbook of Endoscopic Ultrasonography. Seoul: Jin; 2011.Google Scholar
Chung IK, Hawes RH. Advantages and limitations of endoscopic ultrasonography in the evaluation and management of patients with gastrointestinal submucosal tumors: a review. Rev Gastroenterol Disord. 2007;7:179–92.PubMedGoogle Scholar
Humphris JL, Jones DB. Subepithelial mass lesions in the upper gastrointestinal tract. J Gastroenterol Hepatol. 2008;23:556–66.CrossRefPubMedGoogle Scholar
Hwang JH, Rulyak SD, Kimmey MB, et al. American Gastroenterological Association Institute technical review on the management of gastric subepithelial masses. Gastroenterology. 2006;130:2217–28.CrossRefPubMedGoogle Scholar