Clinical Endoscopy

Case Report

A rare case of esophageal mucoepidermoid carcinoma successfully treated via endoscopic submucosal dissection: So Eun Jeun, Kyung Bin Kim, Bong Eun Lee, Gwang Ha Kim, Moon Won Lee, Dong Chan Joo; Clin Endosc 2024;57(5):683-687. Published online June 18, 2024; DOI: https://doi.org/10.5946/ce.2024.051

Abstract PDF PubReader ePub: Esophageal mucoepidermoid carcinoma (EMEC) is a special subtype of esophageal malignancy, accounting for less than 1% of all cases of primary esophageal carcinoma. Pathologically, it consists of a mixture of adenocarcinoma and squamous cell carcinoma with mucin-secreting cells. Special staining for mucicarmine helps to diagnose EMEC. We present a rare case of EMEC successfully treated via endoscopic submucosal dissection (ESD). A 63-year-old man was referred to our tertiary hospital. On esophagogastroduodenoscopy, a 6-mm-sized subtle reddish depressed lesion was identified in the mid-esophagus. Diagnostic ESD was performed with a high suspicion of carcinoma. Histopathologic findings were consistent with EMEC which was confined to the lamina propria without lymphatic invasion. We plan to do a careful follow-up without administering adjuvant chemotherapy or radiotherapy. Due to the small volume of the lesion, establishing a diagnosis was difficult through forceps biopsy alone. However, by using ESD, we could confirm and successfully treat a rare case of early-stage EMEC.

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Brief Reports

Large Jejunal Phytobezoar with Small Bowel Obstruction Treated by Single-Balloon Enteroscopy: Eun Young Park, Dong Hoon Baek, Bong Eun Lee, Gwang Ha Kim, Geun Am Song; Clin Endosc 2022;55(2):310-312. Published online November 6, 2020; DOI: https://doi.org/10.5946/ce.2020.215

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Endoscopic Submucosal Dissection of an Inverted Pyloric Gland Adenoma Using Dental Floss and Clip Traction: Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Do Youn Park; Clin Endosc 2021;54(6):935-936. Published online August 31, 2020; DOI: https://doi.org/10.5946/ce.2020.164

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Citations

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Synchronous gastric MALT lymphoma and gastric adenocarcinoma of fundic gland type arising from a hamartomatous inverted polyp in a Helicobacter pylori naive patient
Ryo Miyamoto, Hidehiko Takigawa, Takahiro Kotachi, Hiroki Kadota, Ryo Yuge, Ryohei Hayashi, Yuji Urabe, Akira Ishikawa, Kazuhiro Sentani, Shiro Oka
Clinical Journal of Gastroenterology.2023; 16(4): 521. CrossRef
The Many Faces of Gastric Inverted Polyps: a case report
S.I. Kim, M.Y. Agapov, T.F. Savostyanov, A.A. Paratovskaya, I.A. Sokolova
Dokazatel'naya gastroenterologiya.2023; 12(2): 88. CrossRef
Pyloric Gastric Adenoma: Endoscopic Detection, Removal, and Echoendosonographic Characterization
Anabel Liyen Cartelle, Erik A. Holzwanger, Samuel Igbinedion, Sultan Mahmood, Harry J. Rosenberg, Tyler M. Berzin, Mandeep S. Sawhney, Moamen Gabr, Douglas K. Pleskow
ACG Case Reports Journal.2023; 10(12): e01229. CrossRef

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Case Report

A Rare Case of Early Gastric Cancer Combined with Underlying Heterotopic Pancreas: Jung Bin Yoon, Bong Eun Lee, Dae Hwan Kim, Do Youn Park, Hye Kyung Jeon, Dong Hoon Baek, Gwang Ha Kim, Geun Am Song; Clin Endosc 2018;51(2):192-195. Published online August 31, 2017; DOI: https://doi.org/10.5946/ce.2017.055

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Heterotopic pancreas in the stomach is usually asymptomatic and benign. Here, we presented a rare case of an early gastric cancer overlying a heterotopic pancreas. A 48-year-old woman underwent esophagogastroduodenoscopy, which revealed a subepithelial mass measuring 2.0×1.5 cm on the gastric antrum with a 1-cm erosive erythematous discoloration on the surface. A biopsy specimen showed moderately differentiated tubular adenocarcinoma. Endosonography showed a heterogeneous hypoechoic mass measuring 1.3×0.6 cm, with indistinct margins in the second and third layers of the gastric wall; anechoic tubular structures within the mass were suggestive of heterotopic pancreas. Distal gastrectomy was performed, which confirmed an early gastric cancer confined to the mucosa, and a separate underlying heterotopic pancreas. Although heterotopic pancreas is most likely benign, careful endoscopic observation of the mucosal surface is necessary to avoid overlooking a coincident early gastric cancer.

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Duodenal Heterotopic Pancreas with a Large Retention Cyst: A Case Report and Literature Review
Shinya Kawaguchi, Akinori Murakami, Masato Nishida
Internal Medicine.2023; 62(5): 723. CrossRef
Gastric ectopic pancreas combined with synchronous multiple early gastric cancer: A rare case report
Zhen-Ya Zhao, Yue-Xing Lai, Ping Xu
World Journal of Clinical Cases.2023; 11(7): 1569. CrossRef
A rare case of enlarged gastric heterotopic pancreas with retention cysts: A case report and literature review
Keiso Matsubara, Michihiro Ishida, Toshiaki Morito, Tetsushi Kubota, Yasuhiro Choda, Masao Harano, Hiroyoshi Matsukawa, Hitoshi Idani, Shigehiro Shiozaki, Masazumi Okajima
International Journal of Surgery Case Reports.2020; 74: 284. CrossRef
A case of gastric heterotopic pancreas with gastroduodenal invagination
Shoko Iwahashi, Masaaki Nishi, Toshiaki Yoshimoto, Hideya Kashihara, Chie Takasu, Takuya Tokunaga, Tomohiko Miyatani, Jun Higashijima, Kozo Yoshikawa, Yuma Wada, Yoshimi Bando, Mitsuo Shimada
Surgical Case Reports.2019;[Epub] CrossRef

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Commentary

Characteristics of Missed Synchronous Gastric Epithelial Neoplasms: Bong Eun Lee; Clin Endosc 2017;50(3):211-212. Published online May 31, 2017; DOI: https://doi.org/10.5946/ce.2017.058

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Clinicopathological features and risk factors analysis of lymph node metastasis and long-term prognosis in patients with synchronous multiple gastric cancer
Liang Chen, Chao Yue, Gang Li, Xuezhi Ming, Rongmin Gu, Xu Wen, Bin Zhou, Rui Peng, Wei Wei, Huanqiu Chen
World Journal of Surgical Oncology.2021;[Epub] CrossRef

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110 Download
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Original Article

Endosonographic Features of Gastric Schwannoma: A Single Center Experience: Jong Min Yoon, Gwang Ha Kim, Do Youn Park, Na Ri Shin, Sangjeong Ahn, Chul Hong Park, Jin Sung Lee, Key Jo Lee, Bong Eun Lee, Geun Am Song; Clin Endosc 2016;49(6):548-554. Published online March 15, 2016; DOI: https://doi.org/10.5946/ce.2015.115

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Background
/Aims: Gastric schwannomas are rare benign mesenchymal tumors that are difficult to differentiate from other mesenchymal tumors with malignant potential, such as gastrointestinal stromal tumors. This study aimed to evaluate the characteristic findings of gastric schwannomas via endoscopic ultrasonography (EUS).
Methods
We retrospectively reviewed the EUS findings of 27 gastric schwannoma cases that underwent surgical excision at Pusan National University Hospital during 2007 to 2014.
Results
Gastric schwannomas were mainly located in the middle third of the stomach with a mean tumor size of 32 mm. All lesions exhibited hypoechoic echogenicity, and 24 lesions (88.9%) exhibited heterogeneous echogenicity. Seventeen lesions (63.0%) exhibited decreased echogenicity compared to the normal proper muscle layer. Distinct borders were observed in 24 lesions (88.9%), lobulated margins were observed in six lesions (22.2%), and marginal haloes were observed in 24 lesions (88.9%). Hyperechogenic spots were observed in 21 lesions (77.8%), calcifications were observed in one lesion (3.7%), and cystic changes were observed in two lesions (7.4%).
Conclusions
During EUS, gastric schwannomas appear as heterogeneously hypoechoic lesions with decreased echogenicity compared to the normal proper muscle layer. These features may be helpful for differentiating gastric schwannomas from other mesenchymal tumors.

Citations

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Gastric schwannoma: The gastrointestinal tumor simulator - case report and review of the literature
Amine Majdoubi, Anass El Achchi, Mohamed El Hammouti, Tareq Bouhout, Badr Serji
International Journal of Surgery Case Reports.2024; 116: 109389. CrossRef
Schwannoma gástrico. Reporte de un caso
Darío Montes N, Nixon Cevallos R, Rubén Montes N
Oncología (Ecuador).2024; 34(1): 52. CrossRef
Artificial Intelligence-Based Diagnosis of Gastric Mesenchymal Tumors Using Digital Endosonography Image Analysis
Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Ji Woo Kim, Kwang Baek Kim
Journal of Clinical Medicine.2024; 13(13): 3725. CrossRef
Shwannoma of the stomach and synchronous cancer of the transverse colon: a clinical case report
A. B. Baychorov, M. A. Danilov, N. C. Karnaukhov, Z. M. Abdulatipova, A. V. Leontiev, G. G. Sahakyan
Surgery and Oncology.2023; 13(3): 38. CrossRef
Systematic Endoscopic Approach for Diagnosing Gastric Subepithelial Tumors
Gwang Ha Kim
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The Diagnosis of Small Gastrointestinal Subepithelial Lesions by Endoscopic Ultrasound-Guided Fine Needle Aspiration and Biopsy
Masanari Sekine, Takeharu Asano, Hirosato Mashima
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Hailing Peng, Liu Han, Yuyong Tan, Yi Chu, Liang Lv, Deliang Liu, Hongyi Zhu
Frontiers in Oncology.2022;[Epub] CrossRef
What About Gastric Schwannoma? A Review Article
Sara Lauricella, Sergio Valeri, Gianluca Mascianà, Ida Francesca Gallo, Erica Mazzotta, Chiara Pagnoni, Saponaro Costanza, Lorenza Falcone, Domenico Benvenuto, Marco Caricato, Gabriella Teresa Capolupo
Journal of Gastrointestinal Cancer.2021; 52(1): 57. CrossRef
Diagnosing Gastric Mesenchymal Tumors by Digital Endoscopic Ultrasonography Image Analysis
Moon Won Lee, Gwang Ha Kim
Clinical Endoscopy.2021; 54(3): 324. CrossRef
Gastric schwannoma with high accumulation on fluorodeoxyglucose-positron emission tomography resected by non-exposed endoscopic wall-inversion surgery
Tomoya Sugiyama, Masahide Ebi, Tomoko Ochiai, Shintaro Kurahashi, Takuya Saito, Kentaro Onishi, Kazuhiro Yamamoto, Satoshi Inoue, Kazunori Adachi, Takashi Yoshimine, Yoshiharu Yamaguchi, Yasuhiro Tamura, Shinya Izawa, Yasutaka Hijikata, Yasushi Funaki, Na
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Schwannoma gástrico: una rareza entre los tumores mesenquimatosos del tracto gastrointestinal
G.E. Sánchez-Morales, A.M. Trolle-Silva, P. Moctezuma-Velázquez, J.H. Rodríguez-Quintero, R.J. Alcazar-Félix
Revista de Gastroenterología de México.2020; 85(1): 102. CrossRef
Gastric schwannoma: A rarity among mesenchymal tumors of the gastrointestinal tract
G.E. Sánchez-Morales, A.M. Trolle-Silva, P. Moctezuma-Velázquez, J.H. Rodríguez-Quintero, R.J. Alcazar-Félix
Revista de Gastroenterología de México (English Edition).2020; 85(1): 102. CrossRef
Clinical Characteristics and Surgical Management of Gastrointestinal Schwannomas
Xin Wu, Binglu Li, Chaoji Zheng, Xiaodong He, Kosei Maemura
BioMed Research International.2020;[Epub] CrossRef
Periampullary duodenal schwannoma mimicking ampullary neoplasm
Marly Pierina Rubio Sierra, Aydamir Alrakawi, Ahmad Alduaij, Dana AlNuaimi, Numan Cem Balci
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Gastric schwannoma: a case report and literature review
Changsheng Pu, Keming Zhang
Journal of International Medical Research.2020;[Epub] CrossRef
Application of A Convolutional Neural Network in The Diagnosis of Gastric Mesenchymal Tumors on Endoscopic Ultrasonography Images
Yoon Ho Kim, Gwang Ha Kim, Kwang Baek Kim, Moon Won Lee, Bong Eun Lee, Dong Hoon Baek, Do Hoon Kim, Jun Chul Park
Journal of Clinical Medicine.2020; 9(10): 3162. CrossRef
Glomus Tumor of the Duodenum
Tae Kyoung Ha, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Young Min Kwak, Guk Bin Park, Yong Bo Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2020; 20(4): 328. CrossRef
Simultaneous organ-sparing surgery in a patient with rare synchronous polyneoplasms of the gastrointestinal tract
D.V. Sidorov, I.V. Stepanyuk, I.A. Bakasov, M.V. Lozhkin, N.N. Volchenko, R.I. Moshurov, N.A. Grishin, E.V. Gameeva
Onkologiya. Zhurnal imeni P.A.Gertsena.2020; 9(6): 67. CrossRef
Digital image analysis-based scoring system for endoscopic ultrasonography is useful in predicting gastrointestinal stromal tumors
Moon Won Lee, Gwang Ha Kim, Kwang Baek Kim, Yoon Ho Kim, Do Youn Park, Chang In Choi, Dae Hwan Kim, Tae Yong Jeon
Gastric Cancer.2019; 22(5): 980. CrossRef
Gastric schwannoma misdiagnosed as a GIST
Roberto Peltrini, Paola Antonella Greco, Riccardo Aurelio Nasto, Alessandra D’Alessandro, Alessandro Iacobelli, Luigi Insabato, Luigi Bucci
Acta Chirurgica Belgica.2019; 119(6): 411. CrossRef
Clinical characteristics and surgical treatment of schwannomas of the esophagus and stomach: A case series and systematic review
Jesús Morales-Maza, Francisco Ulises Pastor-Sifuentes, Germán E Sánchez-Morales, Emilio Sanchez-Garcia Ramos, Oscar Santes, Uriel Clemente-Gutiérrez, Adriana Simoneta Pimienta-Ibarra, Heriberto Medina-Franco
World Journal of Gastrointestinal Oncology.2019; 11(9): 750. CrossRef
Gastric Schwannoma Mimicking Advanced Gastric Cancer
Woo Sun Rou, Ju Seok Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2019; 19(4): 282. CrossRef
Gastrointestinal schwannomas: a rare but important differential diagnosis of mesenchymal tumors of gastrointestinal tract
Alexandros Mekras, Veit Krenn, Aristotelis Perrakis, Roland S Croner, Vasileios Kalles, Cem Atamer, Robert Grützmann, Nikolaos Vassos
BMC Surgery.2018;[Epub] CrossRef
Endosonographic Findings and the Natural Course of Chronic Gastric Anisakiasis: A Single-Center Experience
Eun Young Park, Dong Hoon Baek, Gwang Ha Kim, Bong Eun Lee, So-Jeong Lee, Do Youn Park
Gastroenterology Research and Practice.2018; 2018: 1. CrossRef
A Rare Duodenal Subepithelial Tumor: Duodenal Schwannoma
Dong Hwahn Kahng, Gwang Ha Kim, Sang Gyu Park, So Jeong Lee, Do Youn Park
Clinical Endoscopy.2018; 51(6): 587. CrossRef
Endoscopic ultrasonography diagnosis of subepithelial lesions
Mitsuhiro Kida, Yusuke Kawaguchi, Eiji Miyata, Rikiya Hasegawa, Toru Kaneko, Hiroshi Yamauchi, Shuko Koizumi, Kosuke Okuwaki, Shiro Miyazawa, Tomohisa Iwai, Hidehiko Kikuchi, Maya Watanabe, Hiroshi Imaizumi, Wasaburo Koizumi
Digestive Endoscopy.2017; 29(4): 431. CrossRef
Role of endoscopic ultrasound and endoscopic resection for the treatment of gastric schwannoma
Jinlong Hu, Xiang Liu, Nan Ge, Sheng Wang, Jintao Guo, Guoxin Wang, Siyu Sun
Medicine.2017; 96(25): e7175. CrossRef
Is Endoscopic Ultrasonography Adequate for the Diagnosis of Gastric Schwannomas?
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Case Report

Immunoglobulin G4-Related Inflammatory Pseudotumor Presenting as a Solitary Mass in the Stomach: Hong Ryeol Cheong, Bong Eun Lee, Geun Am Song, Gwang Ha Kim, Sung Gyu An, Won Lim; Clin Endosc 2016;49(2):197-201. Published online February 12, 2016; DOI: https://doi.org/10.5946/ce.2015.074

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Immunoglobulin G4 (IgG4)-related disease (IgG4RD) is a relatively recently recognized entity that is histopathologically characterized by an extensive infiltration of lymphocytes and IgG4-positive plasma cells with dense fibrosis. IgG4RD is now known to affect any organ system, and a few cases of gastrointestinal lesions have also been reported. However, solitary IgG4RD of the stomach is still very rare. Furthermore, as it can mimic malignant conditions, it is important to recognize this disease to avoid unnecessary surgery. Herein, we present a case of IgG4RD presenting as an isolated subepithelial mass in the stomach.

Citations

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Mass-forming immunoglobulin G4-related disease shows indolent clinical course after surgical resection, clinicopathological analysis of a series of 15 cases
Ruoyu Shi, Benjamin Livingston Farah, Chuanhui Xu, Joe Poh Sheng Yeong, Chik Hong Kuick, Jian Yuan Goh, Kenneth Tou En Chang, Angela Takano
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Banumathi Ramakrishna, Rohan Yewale, Kavita Vijayakumar, Patta Radhakrishna, Balakrishnan Siddartha Ramakrishna
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IgG4-related Disease Manifesting as Gastroduodenal Ulcer Diagnosed by an Endoscopic Biopsy
Osamu Muto, Susumu Tamakawa, Kenji Takahashi, Shiro Yokohama, Ai Takasoe, Fuminori Hirano, Hideo Nishimura, Hiroki Saito
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IgG4-related Sclerosing Disease Forming a Gastric Submucosal Tumor Diagnosed after Laparoscopic Endoscopic Cooperative Surgery—Report of a Case—
Tatsuki ISHIKAWA, Katsunori NAKANO, Masafumi OSAKA, Yayoi KADOTANI, Kaori OKUGAWA, Kiyokazu AKIOKA, Kenta SHIGEMORI, Yohei HOSOKAWA
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Betul Piyade, Gurhan Sisman, Serpil Yilmaz, Tayfun Karahasanoglu
European Journal of Gastroenterology & Hepatology.2020; 32(11): 1482. CrossRef
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Yudai Hojo, Yoshiharu Shirakata, Ai Izumi, Jun Matsui, Tokuyuki Yamashita, Hikaru Aoki, Makoto Kurimoto, Masaaki Hirata, Naoki Goda, Hiroaki Ito, Jun Tamura
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Manuel Santiago Mosquera, Andrea Suarez Gómez, Hugo Herrera, Karen Moreno-Medina, Alejandro González-Orozco, Carlos J-Perez Rivera
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Kenji Notohara, Terumi Kamisawa, Kazushige Uchida, Yoh Zen, Mitsuhiro Kawano, Satomi Kasashima, Yasuharu Sato, Masahiro Shiokawa, Takeshi Uehara, Hajime Yoshifuji, Hiroko Hayashi, Koichi Inoue, Keisuke Iwasaki, Hiroo Kawano, Hiroyuki Matsubayashi, Yukitos
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Digestive Diseases and Sciences.2018; 63(4): 1072. CrossRef
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Katsuyuki Miyabe, Yoh Zen, Lynn D. Cornell, Govindarajan Rajagopalan, Vaidehi R. Chowdhary, Lewis R. Roberts, Suresh T. Chari
Gastroenterology.2018; 155(4): 990. CrossRef
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Ali Bohlok, Melody El Khoury, Berenice Tulelli, Laurine Verset, Anthony Zaarour, Pieter Demetter, Pierre Eisendrath, Issam El Nakadi
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The Japanese Journal of Gastroenterological Surgery.2018; 51(10): 599. CrossRef

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