DOCSLIB.ORG

Glomus Tumor of the Stomach Andronik Kapiev MD1, Ron Lavy MD1, Judith Sandbank MD2 and Ariel Halevy MD1

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Glomus Tumor of the Stomach Andronik Kapiev MD1, Ron Lavy MD1, Judith Sandbank MD2 and Ariel Halevy MD1 CASE CoMMUNICATIONS IMAJ • VOL 14 • MArch 2012 Glomus Tumor of the Stomach Andronik Kapiev MD1, Ron Lavy MD1, Judith Sandbank MD2 and Ariel Halevy MD1 1Division of General Surgery and 2Institute of Pathology, Asaf Harofeh Medical Center, Zerifin, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel gastritis. Due to persistent abdominal case with our patient. However, low risk KEY WORDS: glomus tumor, gastrointestinal stromal pain, a computerized tomography scan of and unpredictable malignant behavior tumor, benign tumor of stomach the abdomen was performed revealing a cannot be excluded. There are no data on IMAJ 2012; 14: 192 5.9 x 6 cm antral mass. With a tentative the mode of dissemination, and the only diagnosis of a gastric gastrointestinal report of metastatic spread was to the stromal tumor, the patient underwent an liver. Radiographic and endoscopic inves- astric glomus tumors are rare tumors exploratory laparotomy that showed a 5 tigations are not specific in most cases. G of the gastrointestinal tract originat- cm irregular antral mass, and a sub-total Glomus tumors of the stomach can be dif- ing in the neuromyoarterial glomus struc- gastrectomy was performed with an un- ferentiated from gastrointestinal stromal ture. The first case of a gastric glomus eventful postoperative course. tumors, carcinoid tumors, mucosa-asso- tumor was described by Key et al. in 1951 Pathological evaluation showed the ciated lymphoid tissue lymphoma, gastric [1]. Glomus tumors of the stomach are presence of a population of round homo- lymphoma and other types of tumor usually benign, but malignant behavior genous cells with a hemangiopericytoma- based on morphology and immunohis- cannot be excluded. We present a case of like vascular pattern and no significant tochemical studies [2-4]. When there are non-malignant glomus tumor. proliferative activity (< 2 MF/50 HPF) no signs suggestive of malignancy, limited or necrosis along with immunopositivity resection is the treatment of choice, but for muscle-specific actin, alpha-smooth there are no clinical guidelines as to when PATIENT DESCRIPTION muscle actin and calponin. These fea- to perform a limited resection and when A 37 year old otherwise healthy woman tures support the diagnosis of a glomus to perform gastric resection. The largest was admitted with complaints of upper tumor [Figure]. collected series of glomus tumors was middle abdominal pain, dysphagia and a The morphologic differential diagnosis reported by Miettinen et al. [5]. Since the few episodes of melena. Physical examina- is that of an epithelioid gastrointestinal overall number of cases reported is small, tion and blood tests were within normal stromal tumor. However, in this case the there are not enough data to support an limits. An upper gastrointestinal endos- morphology and the immunophenotype active follow-up. copy revealed no abnormality except – PDGFRA-α (negative) and c-kit (nega- Corresponding author: for Helicobacter pylori-positive chronic tive) – did not support this diagnosis. This Dr. A. Halevy kind of tumor is generally associated with Division of Surgery, Asaf Harofeh Medical Center, a good prognosis, especially when atypia Zerifin 70300, Israel Glomus tumor (hematoxylin & eosin, original magnification Phone: (972-8) 997-9222/3 x400). The tumor consists of homogeneous, middle-sized cells and direct angiolymphatic involvement Fax: (972-8) 977-8225 with low proliferative activity are lacking. email: [email protected] References CoMMENT 1. Key S, Callaahn WP, Murray M. Glomus tumor of the stomach. Cancer 1951; 4: 726-36. The glomus body is a specialized form 2. Lee HW, Lee JJ, Yang DH, Lee BH. DH, Lee BH. of arteriovenous anastomosis involved A clinicopathologic study of glomus tumor of the stomach. J Clin Gastroenterol 2006; 40: 717-20. in thermoregulation [1]. Glomus tumors 3. Kapur U, Hobbs CM, McDermott E, Mooney EE. are typically found in peripheral soft tis- Gastric glomus tumor. Ann Diagn Pathol 2004. 8: sues, but have also been found in other 32-5. organs. The majority of gastrointestinal 4. Miettinen M, Majidi M, Lasota J. Pathology and diagnostic criteria of gastrointestinal stromal tumors glomus tumors are located in the stom- (GISTs): a review. Eur J Cancer 2002; 38 (Suppl 5): ach. Most of these tumors are benign S39-51. and associated with a good prognosis, 5. Miettinen M, Paal E, Lasota J, Sobin LH. Gastro- intestinal glomus tumors: a clinicopathologic, especially when atypia and direct angio- immunohistochemical, and molecular genetic study lymphatic invasion are lacking, as was the of 32 cases. Am J Surg Pathol 2002; 26: 301-11. 192 .
Load more

Recommended publications
  • Case Report Collision Tumor of Carcinoma and Lymphoma in the Cecum: Case Report and Review of Literature
    Int J Clin Exp Pathol 2020;13(11):2907-2915 www.ijcep.com /ISSN:1936-2625/IJCEP0118896 Case Report Collision tumor of carcinoma and lymphoma in the cecum: case report and review of literature Lei Bao*, Xiaoli Feng*, Ting Wang, Fengjuan Xing Department of Pathology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, People’s Re- public of China. *Equal contributors. Received July 25, 2020; Accepted October 23, 2020; Epub November 1, 2020; Published November 15, 2020 Abstract: Collision tumors that occur in the gastrointestinal tract, especially the intestine, are rare, and collisions of carcinoma and lymphoma are even more rare. We report a case of collision tumor with adenocarcinoma and non- Hodgkin’s diffuse large B-cell lymphoma in the cecum of an elderly male patient. Literature was reviewed to explore the clinicopathologic features, differential diagnosis, treatment, and prognosis of collision tumors with carcinoma and lymphoma involving the gastrointestinal tract, to enhance the understanding of this rare tumor, and improve diagnosis and treatment. Keywords: Collision tumor, diffuse large B-cell, lymphoma, carcinoma, gastrointestinal tract Introduction lymphoma from 1969 to now were found the in PubMed database. Diagnosis and treatment Collision tumor is a rare occurrence where two are discussed. different tumors occur in the same organ [1]. Case report Adenocarcinoma is the most common malig- nant tumor of the gastrointestinal tract, while A 77-year-old man presented to the outpatient lymphoma is relatively rare and accounts for department of Gastrointestinal Surgery of the only 1%-4% of all malignant tumors of the gas- Affiliated Yantai Yuhuangding Hospital of Qing- trointestinal tract [2].
    [Show full text]
  • Risk Factors for Mucosal Ulceration in Gastric Gastrointestinal Stromal
    ISSN: 2469-584X Ariam et al. J Clin Gastroenterol Treat 2019, 5:071 DOI: 10.23937/2469-584X/1510071 Volume 5 | Issue 2 Journal of Open Access Clinical Gastroenterology and Treatment CASE REPORT Risk Factors for Mucosal Ulceration in Gastric Gastrointestinal Stromal Tumors (GIST) Eran Ariam1, Anton Bermont1, Yehuda Herskovitz2, Shay Matalon1, Bard Vyacheslav3, Reut Yaakobi4, Daana Baseem4, Fadi Younis5, Asia Zubkov6, Efrat Broide1, Benjamin Avidan7, Steven F Moss8 and Haim Shirin1* 1The Gonczarowski Family Institute of Gastroenterology and Liver Diseases, Shamir (Assaf Harofeh) Medical Center, Sackler School of Medicine, Tel Aviv University, Israel 2Department of Surgery B, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel 3Department of Surgery, Rabin Medical Center, Petach Tikva, Israel 4Pathology Institute, Shamir (Assaf Harofeh) Medical Center Zerifin, Israel 5 Check for Gastroenterology Institute, Sourasky Medical Center, Tel Aviv, Israel updates 6Pathology Institute Sourasky Medical Center, Tel Aviv, Israel 7Gastroenterology Institute, Sheba Medical Center, Ramat Gan, Israel 8Division of Gastroenterology, Department of Medicine, Alpert Medical School, Brown University, Providence, RI, USA *Corresponding author: Haim Shirin, The Gonczarowski Family Institute of Gastroenterology and Liver Disease, Shamir (Assaf Harofeh) Medical Center, Zerifin, 70300, Israel, Tel: 972-8-9779722, Fax: 972-8-9779727 Abstract On univariate analysis, mucosal ulceration in gastric GIST was associated with older age, increased number of mito- Background: Gastrointestinal stromal tumors (GIST) are ses, high Ki-67 index, location in the cardia and fundus and the most common subepithelial tumors in the gastrointesti- an elevated INR. Multivariate analysis showed significant nal (GI) tract and they are usually located in the stomach. differences only for number of mitoses (OR = 1.287, 95% To date, only a few studies have investigated the risk fac- CI 1.054-1.57, p = 0.013).
    [Show full text]
  • Appearance of Krukenberg Tumor from Gastric Carcinoma, US and CT Evaluation
    Short Communication Clinics in Oncology Published: 08 Jul, 2018 Appearance of Krukenberg Tumor from Gastric Carcinoma, US and CT Evaluation Antonio Gligorievski* University Clinic of Surgery "St. Naum Ohridski" Skopje, Macedonia Abstract Introduction: The Krukenberg tumor is a rare malignant tumor of the ovary, accounting from 1% to 2% of all ovarian tumors. It is usually a bilateral involvement of ovaries from the metastatic deposit from adenocarcinoma of the stomach. Patients and Methods: We present a patient at the age of 45, who visited a doctor because of pain in the stomach, nausea, and vomiting and weight loss of more than 20 kg. Clinical, biochemical, endoscopic, pathohistological, radiological and imaging studies (US and CT) have been performed. The radiological examination was performed using a monocontrast and double-contrast technique. The US examination was performed with a 3.75 MHz convex probe, using a standard overview technique. CT was made after oral administration of 700 ml of water, i.v. application of a non-ionic contrast agent of 90 ml in bolus, in hypotonia achieved by i.v. glucagon application, with a scanning width of 10 mm. Presentation of the Case: The radiological finding is in favor of diffuse neoplastic submucosal infiltration of the stomach wall in the region of the corpus and antrum with expressed desmoplastic reaction (linitis plastica). CT findings confirm the radiological findings of the stomach; clearly visualize metastases in the ovaries and peritoneum-ascites, thus diagnosing the primary inoperable neoplastic stomach process - linitis plastica, with metastases in the ovaries - Krukenberg tumor. A comparison of the obtained radiological and imaging results with the endoscopic and pathohistological findings has been made.
    [Show full text]
  • Primary Gastric Sarcoma: Case Report and Literature Review
    DOI: https://doi.org/10.22516/25007440.306 Case report Primary gastric sarcoma: Case report and literature review Helena Facundo Navia, MD,1* Juliana Rendón Hernández, MD,2 Jorge Mesa, MD.3 1 Specialist in Gastrointestinal Surgery and Digestive Abstract Endoscopy at the National Cancer Institute in Bogotá, Colombia Gastric cancer, a neoplastic pathology of undeniable importance, accounts for 90% of cases to adenocarci- 2 Specialist in Gastrointestinal Surgery and Digestive noma. GIST lymphomas and gastrointestinal stromal tumors are the majority of the other 10%. However, non- Endoscopy at the National Cancer Institute in GIST sarcomas remain a possible differential diagnosis to keep in mind and constitute a neoplastic pathology Bogotá, Colombia 3 Specialist in cancer pathology at the National Cancer whose treatment is fundamentally surgical. Leiomyosarcoma represents less than 1% of malignant stomach Institute in Bogotá, Colombia tumors, and the available literature consists of case reports or case series. Because of its rarity, we present this clinical case and review the literature. *Correspondence: Helena Facundo Navia, MD, [email protected] Keywords ......................................... Leiomyosarcoma, gastric neoplasms, mesenchymal tumors. Received: 22/10/18 Accepted: 18/12/18 INTRODUCTION Since that publication, our knowledge of sarcomas has expanded and its classification has been revised on several Primary gastric leiomyosarcoma is a malignant non-epithe- occasions. However, these observations are still clinically lial tumor which originates in cells of the muscular stroma valid and useful. and which frequently metastasizes to the liver and lungs. We present the case of a young man with a family his- It is the most common of sarcomas of the stomach which tory of gastric adenocarcinoma who developed pain and account for less than 2% of gastric cancers around the world.
    [Show full text]
  • The Gastrointestinal Tract Frank A
    91731_ch13 12/8/06 8:55 PM Page 549 13 The Gastrointestinal Tract Frank A. Mitros Emanuel Rubin THE ESOPHAGUS Bezoars Anatomy THE SMALL INTESTINE Congenital Disorders Anatomy Tracheoesophageal Fistula Congenital Disorders Rings and Webs Atresia and Stenosis Esophageal Diverticula Duplications (Enteric Cysts) Motor Disorders Meckel Diverticulum Achalasia Malrotation Scleroderma Meconium Ileus Hiatal Hernia Infections of the Small Intestine Esophagitis Bacterial Diarrhea Reflux Esophagitis Viral Gastroenteritis Barrett Esophagus Intestinal Tuberculosis Eosinophilic Esophagitis Intestinal Fungi Infective Esophagitis Parasites Chemical Esophagitis Vascular Diseases of the Small Intestine Esophagitis of Systemic Illness Acute Intestinal Ischemia Iatrogenic Cancer of Esophagitis Chronic Intestinal Ischemia Esophageal Varices Malabsorption Lacerations and Perforations Luminal-Phase Malabsorption Neoplasms of the Esophagus Intestinal-Phase Malabsorption Benign tumors Laboratory Evaluation Carcinoma Lactase Deficiency Adenocarcinoma Celiac Disease THE STOMACH Whipple Disease Anatomy AbetalipoproteinemiaHypogammaglobulinemia Congenital Disorders Congenital Lymphangiectasia Pyloric Stenosis Tropical Sprue Diaphragmatic Hernia Radiation Enteritis Rare Abnormalities Mechanical Obstruction Gastritis Neoplasms Acute Hemorrhagic Gastritis Benign Tumors Chronic Gastritis Malignant Tumors MénétrierDisease Pneumatosis Cystoides Intestinalis Peptic Ulcer Disease THE LARGE INTESTINE Benign Neoplasms Anatomy Stromal Tumors Congenital Disorders Epithelial Polyps
    [Show full text]
  • Benign Gastric Tumor
    BENIGN GASTRIC TUMOR Case Report of Neurofibroma JOSEPH C. ROOT, M.D. Benign tumors of the stomach are of relatively uncommon occur- rence in our experience, as well as upon the basis of reports in the literature. They are seen with sufficient frequency, however, to warrant consideration if certain findings are present in the clinical course and in the roentgen examination. As with any gastric tumor it is not only the roentgenologist's responsibility to make a diagnosis of neoplasm, but every effort should be made to determine whether the tumor present is benign or malignant. Although this is not always possible, accuracy in the diagnosis of gastric lesions improves with the use of the newer developments in roentgen examination as well as with the use of other new diagnostic aids. Three gastric neurofibromata have been seen at the Cleveland Clinic within the past year. In all of these cases the tumor has been removed surgically, and it has been possible to make a final histologic diagnosis. One of these cases had been followed for approximately one year before operation and had progress examinations, both roentgen and gastroscopic. We wish to report this case in detail because of its diagnostic features, as well as to show the roentgen appearance of the other two neuro- fibromata. CASE REPORT The patient was a man, aged 64, who was first seen at the Clinic in March, 1939. The gastrointestinal complaints at that time were inability to eat heavy and fried foods without abdominal distress, gas, bloating, etc. These symptoms had persisted for several years.
    [Show full text]
  • Surgical Treatment of Gastric Gastrointestinal Stromal Tumor
    J Gastric Cancer 2013;13(1):3-18 http://dx.doi.org/10.5230/jgc.2013.13.1.3 Review Article Surgical Treatment of Gastric Gastrointestinal Stromal Tumor Seong-Ho Kong, and Han-Kwang Yang Department of Surgery, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea Gastrointestinal stromal tumor is the most common mesenchymal tumor in the gastrointestinal tract and is most frequently developed in the stomach in the form of submucosal tumor. The incidence of gastric gastrointestinal stromal tumor is estimated to be as high as 25% of the population when all small and asymptomatic tumors are included. Because gastric gastrointestinal stromal tumor is not completely distinguished from other submucosal tumors, a surgical excisional biopsy is recommended for tumors >2 cm. The surgical principles of gastrointestinal stromal tumor are composed of an R0 resection with a normal mucosa margin, no systemic lymph node dissection, and avoidance of perforation, which results in peritoneal seeding even in cases with otherwise low risk profiles. Laparoscopic surgery has been indicated for gastrointestinal stromal tumors <5 cm, and the indication for laparoscopic surgery is expanded to larger tumors if the above mentioned surgical principles can be maintained. A simple exogastric resection and various transgastric resection techniques are used for gastrointestinal stromal tumors in favorable locations (the fundus, body, greater curvature side). For a lesion at the gastroesophageal junction in the posterior wall of the stomach, enucleation techniques have been tried preserve the organ’s function. Those methods have a theoretical risk of seeding a ruptured tumor, but this risk has not been evaluated by well-designed clinical trials.
    [Show full text]
  • Case Report Plexiform Fibromyxoma of the Stomach: a Case Report and Review of the Literature
    Int J Clin Exp Med 2018;11(3):2770-2777 www.ijcem.com /ISSN:1940-5901/IJCEM0065629 Case Report Plexiform fibromyxoma of the stomach: a case report and review of the literature Feng Wang1*, Xiaogang Yan2*, Fei Peng3, Chaofeng Tang1, Di Liu1, Jianjun Song1, Zuozheng Wang1, Bendong Chen1, Qi Wang1 1Department of Hepatobiliary Surgery, General Hospital of Ningxia Medical University, Ningxia, China; 2Depart- ment of Surgical Oncology, The First People’s Hospital of Yinchuan City, Ningxia, China; 3Clinical Medicine, Ningxia Medical University, Ningxia, China. *Equal contributors. Received September 14, 2017; Accepted January 16, 2018; Epub March 15, 2018; Published March 30, 2018 Abstract: Background: Plexiform fibromyxoma (PF) is a recently described rare type of mesenchymal tumor of the stomach that is characterized by a peculiar plexiform growth pattern, myxoid stroma, and spindle-shaped myofibro- blastic cells. PFs are mainly located in the antrum of the stomach, and are treated by distal or partial gastrectomy. This study reports a rare case of PF that occurred in the body of the stomach. A review of PF cases reported in both English and Chinese literature is also provided. Case report: A 52-year-old Chinese female presented with 1-month of intermittent upper abdominal pain. Gastroscopy and computed tomography (CT) revealed a submucosal mass with a small overlying mucosal ulceration in the gastric wall at the mid greater curvature of the stomach. Intraopera- tive rapid frozen section suggested the benign nature of the tumor and the patient underwent gastroscope-assisted laparoscopic wedge resection. Pathological examination of the resected specimen revealed plexiform growth of spindle cells without nuclear atypia and abundant myxoid capillary-rich extracellular matrix.
    [Show full text]
  • Gastric Carcinoid: the Invisible Tumor!
    Open Access Case Report DOI: 10.7759/cureus.13556 Gastric Carcinoid: The Invisible Tumor! Samyak Dhruv 1 , Shamsuddin Anwar 1 , Abhishek Polavarapu 2 , Deeb Liliane 3 1. Internal Medicine, Northwell Health, New York, USA 2. Gastroenterology, Northwell Health, New York, USA 3. Gatsroenterology, Northwell Health, New York, USA Corresponding author: Samyak Dhruv, [email protected] Abstract Neuroendocrine tumor (NET) of the stomach or gastric carcinoid (GC) is a rare tumor derived from enterochromaffin-like (ECL) cells of the stomach and is more common in women after the fifth decade of life. The incidence of GC has been recently trending up. While most GC are visible lesions upon direct visualization on endoscopy, one-fourth of these tumors are intramucosal and not readily identified on upper endoscopy. Thus, a complete gastric map with biopsies of antrum, body, and fundus is required to confirm the presence of carcinoid growth. Herein we report a rare case of GC which was identified on a random gastric biopsy specimen. Categories: Internal Medicine, Gastroenterology, Oncology Keywords: gastric tumor, gastrointestinal carcinoid tumor, upper endoscopy Introduction Neuroendocrine tumors (NETs) are a highly heterogeneous group of neoplasms that originates from the cells of the endocrine and nervous systems distributed throughout the body. They most commonly arise from the gastrointestinal tract where they are called carcinoids [1]. Such tumors arising from the gastric mucosa are defined as gastric NET or gastric carcinoid (GC). These neoplasms are rare comprising 1% of all NETs and 1.8% of gastric cancers [2]. The incidence of GC is around 4.85 per 1,00,000 patients but has been recently trending up [3].
    [Show full text]
  • Metastasizing Leiomyoma of the Stomach Perry J
    METASTASIZING LEIOMYOMA OF THE STOMACH PERRY J. MELNICK, M.D. From the Department of Surgical Pathology, Cook County Hospital, Dr. Richard II. Joffe, Director INTRODUCTION Benign mesenchymatous tumors of the stomach are considered rare. Various types have been described; myomas occur most frequently. Although related anatomically to myomas of other parts of the gastro-intestinal tract, those of the stomach form a more or less distinct clinical entity. The first review of the subject, appearing in 1898, was by Steiner (1) who collected all the reported cases of gastro-intestinal 'myomas beginning with one described by Morgagni in 17(>5; 21 were in the stomach. Hake (2) in 1912 added 60 cases, 36 in the stomach. A year later, Outland and Clendenning (3), restricting their report to myomas of the stomach, collected 79 cases. The same year Farr and Glenn (4) brought the number up to 84. Nasetti (5) in an accurate review collected 140 cases up to 1914. Eliason, Pendergrass, and Wright (6) in 1925 collected 321 cases; but Nigrisoli (7), writing in 1927, considered not all of these authentic, and cited only 211 cases. Since Nigrisoli's review a total of 108 cases have been reported by the following: Larsen (8), Troell (9), Brayne and Simon (10), McIntosh (11), Millar (12), Mason and Dwyer (13), Willenbacher (14), Lorenz (15), Schneide­ wind (16), Schosserer (17), Picard (18), Vance (19), Villata (20), Vernengo (21), Anzilotti (22), Domanig (23), Willis (24), Rieniets (25), Morgan (26), Kahn (27), Emmert (28), Baumeker (29), and Davidson (30). The total number of published cases is therefore 319.
    [Show full text]
  • Giant Gastrointestinal Stromal Tumor with Predominantly Cystic Changes
    Wang et al. World Journal of Surgical Oncology (2017) 15:220 DOI 10.1186/s12957-017-1285-2 CASE REPORT Open Access Giant gastrointestinal stromal tumor with predominantly cystic changes: a case report and literature review Liying Wang1*, Libin Liu1, Zhaohui Liu1, Yueli Tian1 and Zhe Lin2 Abstract Background: Gastrointestinal stromal tumors (GISTs) rarely present with predominantly cystic changes. Here, we report a case of giant GIST of the stomach with predominantly cystic changes in a 74-year-old female patient. Case presentation: The tumor was 10 cm × 15 cm in size and positive for CD117, H-caldesmon, and DOG-1. Complete surgical resection was performed without regional lymphadenectomy. The patient recovered uneventfully and no recurrence occurred. Conclusions: The case illustrates that GIST with cystic changes should be considered in the diagnoses of hepatic and pancreatic lesions. Furthermore, immunohistochemistry with CD117, DOG1, and other molecular markers is critical for diagnosis of GIST of the stomach and facilitates optimization of treatments for GIST. Keywords: Gastrointestinal stromal tumor, Stomach, Cyst, Diagnosis Background 5years;thebloodpressurewasashighas190/90mmHg, Gastrointestinal stromal tumor (GIST) is the most com- and the patient took oral nifedipine (30 mg/day, sustained mon mesenchymal tumor of the digestive tract. Although release tablet, Bayer). GISTs only occur in less than 5% of all gastrointestinal tract Physical examination at admission showed tenderness in tumors, they account for 60% of all gastric stromal tumors the mid and upper left abdomen, but no rebound tenderness [1]. GISTs are typically solid tumors and rarely present with was elicited. A mass was palpated in the upper left abdo- predominantly cystic changes [2].
    [Show full text]
  • The Role of Endoscopy in the Management of Premalignant and Malignant Conditions of the Stomach
    GUIDELINE The role of endoscopy in the management of premalignant and malignant conditions of the stomach This is one of a series of statements discussing the use of Upper GI Tract” has been expanded to include discussion GI endoscopy in common clinical situations. The Stan- of malignant conditions of the stomach.2 ASGE documents dards of Practice Committee of the American Society for addressing the role of endoscopy in malignant and Gastrointestinal Endoscopy (ASGE) prepared this text. In premalignant conditions of the esophagus have been preparing this guideline, a search of the medical litera- recently published.3,4 ture was performed by using PubMed from January 1980 through March 2014 by using the keyword(s) “gastric tumor,”“gastric cancer,”“gastric lymphoma,”“gastric PREMALIGNANT CONDITIONS OF THE and adenocarcinoma,”“gastrointestinal stromal tumor,” STOMACH “gastrointestinal endoscopy,”“endoscopy,”“endoscopic procedures,” and “procedures.” The search was supple- Gastric polyps “ ” mented by accessing the related articles feature of Sporadic gastric epithelial polyps. Gastric polyp fi PubMed, with articles identi ed on PubMed as the refer- histology cannot be reliably distinguished by endoscopic ences. Pertinent studies published in English were re- appearance; therefore, biopsy or polypectomy is warranted viewed. Additional references were obtained from the when polyps are detected.5 The majority (70%-90%) of fi bibliographies of the identi ed articles and from recom- gastric epithelial polyps are fundic gland polyps (FGPs) mendations of expert consultants. When little or no or hyperplastic polyps and are often incidental findings data exist from well-designed prospective trials, emphasis on endoscopy. Sporadic FGPs may develop in association is given to results from large series and reports from with long-term proton pump inhibitor use and are not recognized experts.
    [Show full text]