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Evaluation and Management of Mucosal and Submucosal Lesions in the Foregut

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Upper Endoscopy for GI Fellows

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Abstract

Submucosal or, more appropriately, subepithelial lesions are occasionally seen during upper gastrointestinal endoscopy. A minority turn out to be structures outside the gut wall but most are true intramural lesions. A majority of these lesions are found incidentally and are asymptomatic. Examples of these lesions include malignant or potentially malignant tumors such as gastrointestinal stromal tumors (GISTs) and carcinoids as well as benign lesions (lipoma, duplication cyst, heterotopic pancreas). Diagnosis often cannot be made by endoscopy alone. Endoscopic ultrasound helps narrow the differential diagnosis of a subepithelial lesion based on echogenicity and layer of origin. It also allows for deeper tissue acquisition and evaluation for candidacy for endoscopic resection. Management including endoscopic resection, surgical resection, or surveillance depends on the presence of symptoms, size, and histology if obtained.

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  1. Division of Gastroenterology and Hepatology, University of New Mexico School of Medicine, Albuquerque, USA

    Dino Beduya & Gulshan Parasher

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  1. Dino Beduya
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  2. Gulshan Parasher
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  1. Gastroenterology and Hepatology, Huntsman Cancer Center, University of Utah School of Medicine, Salt Lake City, Utah, USA

    Douglas G. Adler

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EUS of a gastric spindle cell neoplasm (MP4 116736 kb)

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Beduya, D., Parasher, G. (2017). Evaluation and Management of Mucosal and Submucosal Lesions in the Foregut. In: Adler, D. (eds) Upper Endoscopy for GI Fellows. Springer, Cham. https://doi.org/10.1007/978-3-319-49041-0_12

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