Diagnostic value of endoscopic ultrasonography for gastrointestinal leiomyoma

Xu, Guofan; Zhang, Bing-Ling; Li, Youming; Chen, Lihua; Ji, Feng; Chen, Weixing; Cai, Suping

doi:10.3748/wjg.v9.i9.2088

Cited by 51 publications

(45 citation statements)

References 21 publications

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“…Leiomyosarcoma of the large intestine is extremely rare, only accounting for 0.1% of colonic malignancy [12] . With regard to differential diagnosis of leiomyomas and leiomyosarcomas, it is suggested to distinguish according to the size and the internal ultrasonsic characteristics of the tumor in literature.…”

Section: Discussionmentioning

confidence: 99%

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Role of endoscopic miniprobe ultrasonography in diagnosis of submucosal tumor of large intestine

Zhou

Yao²,

Zhong³

et al. 2004

WJG

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AIM:To evaluate the role of miniprobe ultrasonography under colonoscope in the diagnosis of submucosal tumor of the large intestine, and to determine its imaging characteristics. METHODS:Thirty-five patients with submucosal tumors of the large intestine underwent miniprobe ultrasonography under colonoscope. The diagnostic results of miniprobe ultrasonography were compared with pathological findings of specimens by biopsy and surgical resection. RESULTS:Lipomas were visualized as hyperechoic homogeneous masses located in the submucosa with a distinct border. Leiomyomas were visualized as hypoechoic homogeneous mass originated from the muscularis propria. Leiomyosarcomas were shown with inhomogeneous echo and irregular border. Carcinoids were presented as submucosal hypoechoic masses with homogenous echo and distinct border. Lymphangiomas were shown as submocosal hypoechoic masses with cystic septal structures. Malignant lymphomas displayed as hypoechoic masses from mucosa to muscularis propria, while pneumatosis cystoids intestinalis originated from submucosa with a special sonic shadow. One large leiomyoma was misdiagnosed as leiomyosarcoma. CONCLUSION:Endoscopic miniprobe ultrasonography can provide precise information about the size, layer of origin, border of submucosal tumor of the large intestine and has a high accuracy in the diagnosis of submucosal tumor of the large intestine. Pre-operative miniprobe ultrasonography under colonoscope may play an important role in the choice of therapy for submucosal tumor of the large intestine.Zhou PH, Yao LQ, Zhong YS, He GJ, Xu MD, Qin XY. Role of endoscopic miniprobe ultrasonography in diagnosis of submucosal tumor of large intestine.

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Section: Discussionmentioning

confidence: 99%

“…Myogenic tumors were found to be originated from the fourth layer (mp). According to literature, some myogenic tumors were from muscularis mucosa [12] . The size of SMT can be measured with EUS.…”

Section: Discussionmentioning

confidence: 99%

Role of endoscopic miniprobe ultrasonography in diagnosis of submucosal tumor of large intestine

Zhou

Yao²,

Zhong³

et al. 2004

WJG

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“…This approach is a valid alternative to invasive surgery when the complete removal of the lesion is ensured 5,32 . However, it may lead to hemorrhage and perforation 1,2,32,34 . Therefore, endoscopic resection is improper to leiomyosarcoma and leiomyoma of ≥2 cm diameter or originated in the muscularis propria, due to the risk of hemorrhage and perforation 32 .…”

Section: Reportmentioning

confidence: 99%

“…Thus, it is extremely important to determine the layer of lesion origin 32 . In this context, endoscopic ultrasound will help decide about the proper surgical procedure 1,7,11,14,18,34 , as the distinction from the lesion origin layer is important for the proper surgical planning 2,11,14,34 . Usually, leiomyomas originated in the muscularis mucosa can be endoscopically resected, while for those originated in the muscularis propria, this procedure should be avoided 34 .…”

Section: Reportmentioning

confidence: 99%

Treatment of rectal leiomyoma by endoscopic resection

Denadai¹,

Saad-Hossne

Ferraz³

et al. 2011

J. Coloproctol. (Rio J.)

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Leiomyomas of the rectum are rare, with low reported incidence in literature. In most cases, patients are asymptomatic, and are often incidental endoscopic findings. The difficult distinction from leiomyosarcomas, associated with the possibility of recurrence, implies the absence of a standard treatment. Endoscopic resection, if well indicated, may be a therapeutic option. In this study, we report two cases of asymptomatic leiomyoma of the rectum in two patients, discovered incidentally during a routine colonoscopy, removed by conventional polypectomy and discuss its diagnostic and therapeutic aspects based on a literature review.
Os leiomiomas de reto são raros, com baixa incidência relatada na literatura; na maioria dos casos os pacientes são assintomáticos, sendo que em muitos casos são achados incidentais endoscópicos. A dificuldade de distinguí-los dos leiomiossarcomas, aliada a possibilidade de recorrência, implica na inexistência de um tratamento padrão. A ressecção endoscópica desde que bem indicada pode ser uma opção terapêutica. Reportamos dois casos de leiomioma de reto assintomáticos em dois pacientes, descobertos casualmente durante exame colonoscópico de rotina, removidos por polipectomia convencional e discutimos seus aspectos diagnósticos e terapêuticos, através de uma revisão da literatura

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“…Whereas most of the gastric leiomyomas originated from muscularis propria, and the size was 1-2 cm. Almost all the patients with gastrointestinal leiomyoma only had a single lesion, which often progressed slowly or had no change [12][13][14] . Among the 256 patients with gastrointestinal true submucosal lesions, 122 patients accepted further treatment of endoscopic resection, surgical excision, or puncture.…”

Section: Value Of Mups In Diagnosing Gastrointestinal Submucosal Lesionsmentioning

confidence: 99%

Miniature ultrasonic probes for diagnosis and treatment of digestive tract diseases

Li²,

Han³

et al. 2004

WJG

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AIM:To investigate the clinical value of miniature ultrasonic probes (MUPs) for the diagnosis and treatment of digestive tract diseases. METHODS:Endoscopic ultrasonography (EUS) was performed for patients with its indications with 7.5-20 MHz MUPs and double-cavity electronic endoscope. According to the diagnosis of MUPs, patients who had indications of treatment received endoscopic resection or surgical excision. Postoperative histological results were compared with the preoperative diagnosis of MUPs. A few patients without endoscopic resection or surgical excision were periodically followed up with MUPs. RESULTS:A total of 537 patients were examined by MUPs, of them, 256 were diagnosed with gastrointestinal submucosal lesions, 146 with pseudo-submucosal lesions, 50 with digestive tract cancers, 17 with peptic ulcer, 11 with cholecystolithiasis, 8 with chronic pancreatitis, and 2 with achalasia and 47 were diagnosed as normal. After MUPs examinations, 220 patients received endoscopic resection or surgical excision, and the postoperative histological results of 211 patients were completely consistent with the preoperative diagnosis of MUPs. The diagnostic accuracy of MUPs was 95.9%. The result of follow-up with MUPs indicated that gastrointestinal leiomyoma, lipoma, phlebangioma and cyst were unchanged within 1-2 years. The patients who received endoscopic resection or centesis did not have any complications. CONCLUSION:MUPs are of value in diagnosing gastrointestinal submucosal lesions, staging of digestive tract cancers and biliary-pancreatic diseases. They play a very important role in making therapeutic plans.

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Diagnostic value of endoscopic ultrasonography for gastrointestinal leiomyoma

Abstract: The size and layer origin of esophageal leiomyomas are different from that of gastric leiomyomas. Being safe and accurate, EUS is the best method not only for gastrointestinal leiomyoma diagnosis but also for the follow-up of patients.

Cited by 51 publications

References 21 publications

Role of endoscopic miniprobe ultrasonography in diagnosis of submucosal tumor of large intestine

Role of endoscopic miniprobe ultrasonography in diagnosis of submucosal tumor of large intestine

Treatment of rectal leiomyoma by endoscopic resection

Miniature ultrasonic probes for diagnosis and treatment of digestive tract diseases

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