Korean J Gastroenterol.  1999 Nov;34(5):593-600.

Endosonographic Criteria for Differential Diagnosis between Benign and Malignant Stromal Cell Tumor in Gastroduodenum

• Heo JH
• Roe IH
• Lee MI
• Oh HT
• Kim HY
• Kim IH
• Lim CY

Abstract

BACKGROUND/AIMS: Endoscopic ultrasonography (EUS) is a useful technique for demonstrating the muscular origin of gastrointestinal submucosal tumor. This study was to define the EUS features in differential diagnosis for benign and malignant stromal cell tumor.
METHODS
EUS was performed for 19 patients who had stromal cell tumor confirmed surgically (12 benign cases and 7 malignant cases). Upon the results of EUS, we compared maximum tumor diameter, echo texture, outer margin, presence of cystic spaces, echogenic foci and ulceration between benign and malignant stromal cell tumor.
RESULTS
Tumor size, heterogeneity, irregular outer margin and presence of cystic spaces were significantly associated with malignancy. Namely, EUS maximum tumor size greater than 4 cm was observed in 85.7% of the malignancy and 8.3% of the benign stromal cell tumor (p=0.001). Echo-heterogeneity was observed in all of the malignancy and in 8.3% of the benign tumor (p=0.0002). Outer margin was irregular in 85.7% of the malinancy and in none of the benign tumor (p=0.0003). Presence of cystic spaces (>3 mm) was found in 85.7% of the malignancy and in 8.3% of the benign stromal cell tumor (p=0.001). However, presence of echogenic foci (>3 mm) or central ulceration was not associated with the risk of malignancy.
CONCLUSIONS
The EUS features are significantly important to differentiate malignancy from benign stromal cell tumor and may aid the selection of patients for operative treatment.

Keyword

Endoscopic ultrasonography; Benign stromal cell tumor; Malignant stromal cell tumor; Differential diagnosis

MeSH Terms

Diagnosis, Differential*
Endosonography
Humans
Population Characteristics
Stromal Cells*
Ulcer