Cystic submucosal tumors in the gastrointestinal tract: Endosonographic findings and endoscopic removal

Background and study aims: The aim of the present study was to describe the endosonographic findings in gastrointestinal cystic submucosal tumors. Patients and methods: The endosonographic and clinico-pathological findings in 51 patients with a confirmed diagnosis of cystic submucosal tumors were reviewed. Results: Endosonographically, cystic submucosal tumors were classified into simple cystic, multicystic, and solid cystic tumor types. The simple cystic tumor type was frequently identified in cysts, and rarely in Brunner's gland hamartomas or in heterotopic gastric mucosa. The multicystic tumor type was common in lymphangiomas, followed by gastric cystic malformations, hemangiomas, and Brunner's gland hamartomas. The solid cystic tumor type included duplication cysts, heterotopic gastric mucosa, heterotopic pancreas, myogenic tumors with advanced cystic degeneration, and gastric tuberculomas. Based on the endosonographic findings, 14 lesions were safely treated with endoscopic removal, using in particular the unroofing technique (cutting off the upper part of the tumors) in nine lesions. Conclusions: Endosonography is a useful diagnostic modality for investigating cystic submucosal tumors.