Clinical Endoscopy

Case Report

Endoscopic Submucosal Dissection of a Colonic Calcifying Fibrous Tumor: Jaeyoung Kim, Seongyul Ryu, Yeon-Ji Kim; Clin Endosc 2020;53(4):487-490. Published online January 21, 2020; DOI: https://doi.org/10.5946/ce.2019.138

A 49-year-old woman was referred to our hospital for further treatment due to the suspicion of a submucosal tumor in a routine screening colonoscopy. On colonoscopy, a 1-cm sized subepithelial mass with normal overlying mucosa in the hepatic flexure was found. Endoscopic ultrasonography (EUS) showed a homogenous hypoechoic lesion arising from the second and third layer. We were unable to make a final diagnosis because the lesion showed a small tumor with atypical macroscopic morphology including EUS findings. Therefore, endoscopic submucosal dissection was performed for the diagnostic treatment of the tumor. Submucosal dissection was performed just above the muscle layer, and the tumor was removed completely and reliably without any acute complications such as perforation. Based on histopathological findings, we diagnosed a benign, calcifying fibrous tumor (CFT). The present case is the first report of successful endoscopic diagnosis and treatment of colonic CFT mimicking a submucosal tumor.

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Focused Review Series: Recent Update of Endoscopic Ultrasonography in Gastrointestinal Subepithelial Tumors

Current Status of Endoscopic Ultrasonography in Gastrointestinal Subepithelial Tumors: Sang Gyun Kim, Ji Hyun Song, Joo Ha Hwang; Clin Endosc 2019;52(4):301-305. Published online July 9, 2019; DOI: https://doi.org/10.5946/ce.2019.024

Abstract PDF PubReader ePub

Gastrointestinal subepithelial tumors (GSTs) are usually detected incidentally on endoscopic or radiologic examinations. In conventional endoscopy, a GST usually presents as a protuberant lesion with an intact mucosal surface. As the lesion is located beneath the mucosal layer of the gastrointestinal tract, conventional biopsy typically does not reveal the pathologic diagnosis. First, a GST should be differentiated from an extrinsic compression through the positional change of the patient during conventional endoscopic examination. In cases of GSTs originating from the gastrointestinal wall, endoscopic ultrasonography (EUS) can be beneficial for narrowing the differential diagnosis through delineation of echo findings and by determining the layer of origin. EUS findings can also help determine the management strategies for GSTs by making a differential diagnosis according to malignant potential.

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