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Song, Kim, Kim, Cho, Kim, Cheung, Park, and Kim: Endoscopic Characteristics of Upper Gastrointestinal Mesenchymal Tumors Originating from Muscularis Mucosa or Muscularis Propria
Original Article

Korean J Gastroenterol 2013;62(2):92-96.

Published online: 4 October 2013

DOI: https://doi.org/10.4166/kjg.2013.62.2.92

Endoscopic Characteristics of Upper Gastrointestinal Mesenchymal Tumors Originating from Muscularis Mucosa or Muscularis Propria

Jun Ho Song, Jin Il Kim, Hyun Jin Kim, Hyung Jun Cho, Hye Kang Kim, Dae Young Cheung, Soo-Hern Park, Jae Kwang Kim

Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea

Correspondence to: Jin Il Kim, Department of Internal Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, 10 63-ro, Yeongdeungpo-gu, Seoul 150-713, Korea. Tel: +82-2-3779-1519, Fax: +82-2-3779-1331, E-mail: jikim@catholic.ac.kr

Received 13 May 2013       Revised 18 June 2013       Accepted 28 June 2013

Copyright © 2013 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims

Subepithelial tumors are occasionally found during upper gastrointestinal endoscopy. The purpose of this study was to evaluate endoscopic characteristics of mesenchymal tumors originating from muscularis mucosa or muscularis propria.

Methods

A total of 307 mesenchymal tumors of the upper gastrointestinal tract were diagnosed between March 2006 and February 2012 at Yeouido St. Mary's Hospital (Seoul, Korea). Data on endoscopic and endoscopic ultrasonographic findings were collected and analyzed by retrospectively reviewing the medical records.

Results

The mean size of the mesenchymal tumors originating from muscularis mucosa was significantly smaller than those originating from muscularis propria (10.5±6.9 mm vs. 14.3±13.9 mm, p=0.035). The most common locations of the mesenchymal tumors originating from muscularis mucosa and muscularis propria were esophagus (69.1%) and body of the stomach (43.3%), respectively (p＜0.001). Rolling sign was more commonly observed with mesenchymal tumors originating from muscularis mucosa (80.4%, p=0.001), and cushion sign was more frequently absent with those originating from muscularis propria (72.4%, p＜0.001). Internal echo was homogenous in 89.7% and 81.9% of mesenchymal tumors originating from muscularis mucosa and muscularis propria, respectively (p=0.092).

Conclusions

The size, location, and movability of mesenchymal tumors originating from muscularis mucosa were different from those of mesenchymal tumor originating from muscularis propria.

Keywords: Mesenchymal tumor, Subepithelial tumor, Endoscopic ultrasonography

References

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Table 1.
Patient Characteristics and Prevalence of Gastric Symptoms
Variable Muscularis mucosa (n=97) Muscularis propria (n=210) p-value
Sex (male/female) 50/47 92/118 0.206
Age (yr) 53.0±2.1 (19–82) 54.3±11.8 (21–82) 0.980
Gastric symptom     0.283
 Absent 89 (91.8) 184 (87.7)  
 Present 8 (8.2) 26 (12.3)  

Values are presented as n only, mean±SD (range), or n (%).

Table 2.
Endoscopic Features of Upper Gastroinstestinal Subepithelial Tumor
Variable Muscularis mucosa (n=97) Muscularis propria (n=210) p-value
Location     ＜0.001
 Esophagus 67 (69.1) 23 (11.0)  
 Stomach      
  Fundus 11 (11.3) 70 (33.3)  
  Body 4 (4.1) 91 (43.3)  
  Antrum 7 (7.2) 16 (7.6)  
 Duodenum 8 (8.2) 10 (4.8)  
Rolling sign     0.001
 Absent 19 (19.6) 82 (39.0)  
 Present 78 (80.4) 128 (61.0)  
Cushion sign     ＜0.001
 Absent 50 (51.5) 152 (72.4)  
 Present 47 (48.5) 58 (27.6)  
Smooth mucosa     0.439
 Absent 1 (1.0) 6 (2.9)  
 Present 96 (99.0) 204 (97.1)  
Ulcerated mucosa     0.593
 Absent 95 (98.0) 208 (99.0)  
 Present 2 (2.0) 2 (1.0)  
Dimpled mucosa     0.312
 Absent 97 (100.0) 206 (98.0)  
 Present 0 (0.0) 4 (2.0)  

Values are presented as n (%).

Table 3.
Endoscopic Ultrasonographic Features of Upper Gastrointestinal Subepithelial Tumor
Variable Muscularis mucosa (n=97) Muscularis propria (n=210) p-value
Size (mm) 10.5±6.9 14.3±13.9 0.035
Lesion number     0.803
 Single 84 (86.6) 180 (85.7)  
 Multiple 13 (13.4) 30 (14.3)  
Homogeneity     0.092
 Homogenous 87 (89.7) 172 (81.9)  
 Heterogenous 10 (10.3) 38 (18.1)  
Cystic change     1.000
 Absent 96 (99.0) 207 (98.6)  
 Present 1 (1.0) 3 (1.4)  
Hyperechogenic spots     0.824
 Absent 90 (92.8) 192 (91.3)  
 Present 7 (7.2) 18 (8.7)  
Lobulation     0.236
 Absent 95 (98.0) 209 (99.5)  
 Present 2 (2.0) 1 (0.5)  
Border     0.570
 Regular 91 (93.8) 201 (95.7)  
 Irregular 6 (6.2) 9 (4.3)  

Values are presented as mean±SD or n (%).

Table 4.
Pathologic Findings of Upper Gastrointestinal Subepithelial Tumors
　 Muscularis mucosa (n=18) Muscularis propria (n=29)
Leiomyoma 13 20
Gastrointestinal stromal tumor 1 21
Carcinoid tumor 2 0
Neurilemoma 0 1
Schwannoma 0 1
Granular cell tumor 2 0
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