Splenic Cyst Mimicking Gastric Subepithelial Tumor Diagnosed by Endoscopic Ultrasonography

Recent research reveal that the diagnosis of gastric extraluminal compressions mimicking subepithelial tumor is increasing in numbers as esophagogastroduodenoscopy becomes widespread. Endoscopic ultrasonography is a very useful tool for differentiating extraluminal compressions from subepithelial tumors. Gastric extraluminal compressions are due to compression by either normal adjacent organs or pathologic conditions. Pathologic conditions are mainly benign, but some requires operation according to its size. We report a case of a 24-year-old female, who underwent esophagogastroduodenoscopy and was misdiagnosed with gastric subepithelial tumor. Endoscopic ultrasonographic findings showed anechoic cyst outside the gastric wall, which revealed to be a splenic cyst.

The Clinical Significance of Extraluminal Compressions According to the Site of the Stomach / 대한소화기내시경학회지

BACKGROUND/AIMS: It can be difficult to differentiate an extraluminal compression from a true submucosal tumor (SMT) in the stomach. The best method for differentiating an extraluminal compression from a true SMT is endoscopic ultrasonography (EUS). Extragastric compression is frequently observed, but its clinical significance has rarely been reported on. We evaluated the clinical findings of extraluminal compression according to the site of the stomach. METHODS: Ninety-one patients were diagnosed by EUS as having extragastric compressions from January 2006 to July 2008. Abdominal sonography or computed tomography was performed in some cases. RESULTS: The causes of normal structures (64 cases) were the vessels, spleen, intestine, gallbladder, liver, mesentery, pancreas and kidney. The causes of pathologic lesions (27 cases) were hepatic cyst, distended gallbladder with sludge, splenic cyst, hepatic hemangioma, polycystic hepatic and renal disease, pancreatic cyst, renal cyst, calcified lymph node and hepatocelluar carcinoma. The great curvature of the fundus was the most frequent site of extraluminal compressions. The lesions in the anterior wall of the body showed a higher frequency of pathologic lesions than did those lesions in other sites. CONCLUSIONS: EUS is useful for finding the causes of extragastric compression. Careful evaluation is needed because many lesions in the anterior wall of the body of the stomach were due to pathologic causes.

Diagnostic Usefulness of Eedoscopic Ultrasongraphy for Extraluminal Compressions Mimicking Submucosal Tumors / 대한소화기내시경학회지

BACKGROUND/AIMS: When a submucosal lesion is discovered through an upper gastrointestinal endoscopy, it may be often difficult to differentiate an extra-gastric compression from a true submucosa1 tumor (SMT). An endoscopic ultrasonography (EUS) provides information about the relationship between a lesion and the gastric or esophageal wall. Furthermore, EUS helps in identifying the compression caused by surrounding organs. The diagnostic usefulness of EUS for extralumina1 compressed lesion was assessed. METHODS: The 261 patients who received an endoscopic diagnosis of submucosal tumors had EUS examinations performed. The results of EUS to additional diagnostic procedures such as UGI, USG, CT scan or tissue biopsy were then compared. RESULTS: Of 261 patients who received endoseopic diagnosis as SMT, extraluminal compression existed in 46 (17.6%) cases and true intramural lesion were found in 215 (82.4%) cases on EUS. The causes of extraluminal compression are lymph nodes (2 case.), the gallbladder (12 cases), the pancreas (9 cases), the spleen (6 cases), a pancreatic pseudocyst (5 cases), pancreatic cancer (2 cases), a hepatic cyst (2 cases), the left lobe of the liver (4 cases), hepatoma (1 case), a mesenteric tumor (2 caws) and a splenic vein (1 case). CONCLUSIONS: EUS is considered to be a useful diagnostic method not only for differential diagnosis of extraluminal compression from true SWT, but also for clarifying the cause of extraluminal compressed lesions.