Natural History of Asymptomatic Esophageal Subepithelial Tumors of 30 mm or Less in Size

Abstract

Background No definite guidelines for the management of small esophageal subepithelial tumors (SETs) have been established, because there are limited data and studies on their natural history. We aimed to assess the natural history and propose optimal management strategies for small esophageal SETs. Methods Patients diagnosed as esophageal SETs ≤ 30 mm in size between 2003 and 2017 using endoscopic ultrasound (EUS) with a minimal follow-up of 3 months were enrolled, and their esophagogastroduodenoscopy (EGD) and EUS were retrospectively reviewed. Results Of 275 esophageal SETs in 262 patients, the initial size was < 10 mm, 10–20 mm, and 20–30 mm in 104 (37.8%), 105 (38.2%), and 66 (24.0%) lesions, respectively. Only 22 (8.0%) SETs showed significant changes in size and/or echogenicity and/or morphology at a median of 40 months (range, 4–120 months). Tissues of 6 SETs showing interval changes were obtained using EUS-guided fine needle aspiration biopsy; 1 was identified as a gastrointestinal stromal tumor (GIST) and was surgically resected, while the other 5 were leiomyomas and were regularly observed. Eight SETs showing interval changes were resected surgically or endoscopically without pathological confirmation; 1 was a GIST, 2 were granular cell tumors, and the other 5 were leiomyomas. Conclusion Regular follow-up with EGD or EUS may be necessary for esophageal SETs ≤ 30 mm in size considering that small portion of them has a possibility of malignant potential. When esophageal SETs ≤ 30 mm show significant interval changes, pathological confirmation may precede treatment to avoid unnecessary resection.

Leptin Hormone: In Brief

“…It was possible to determine the etiology in none of the lesions with ulcerated mucosa. was similar to the work of that done in South Korea (0.76%) [17]. Still, it was more than double that described by research in Sweden [18], where the prevalence was 0.3%.…”

Formulation and Evaluation of Citronella Oil (Cymbopogon nardus (L.) Rendle) Cream for Acne Treatment

“…This result agrees with Kang et al and is consistent with the nature of cetyl alcohol as a viscosity enhancer. 32 The viscosity result is in agreement with the cream-specific gravity result, where the increase of cetyl alcohol concentration increased the specific gravity. Formula 1 has the lowest specific gravity (0.973 + 0.009 g/mL), while formulas 2, 3, 4, and 5 increased accordingly (1.006 + 0.004, 1.031 + 0.009, 1.055 + 0.006, and 1.082 + 0.007 g/mL, respectively).…”