Subepithelial Tumors in the Stomach: Key Questions Answered

Q: Subepithelial Tumors in the Stomach: Key Questions Answered

Hello Miss Anonymous： It is advisable to confirm the diagnosis first before deciding on the course of action. <br>There are many possibilities for submucosal tumors of the stomach, and generally, the larger the tumor, the higher the chance of malignancy. <br>As for surgery, it wi

Regarding submucosal tumors of the stomach?

Hello, Doctor.
I previously asked you a question and have not received a response yet.
Today, I checked my health record and saw the report from my endoscopy, so I would like to attach it for your clarification.
Here is the text report:
1.
Indication: See request sheet
2.
Procedure: The endoscopic examination was performed in a usual manner to examine the upper digestive tract.
3.
Premedication: (Details see Sedation/Analgesia Care Record) None
4.
Findings & Treatment:
- Esophagus: One mucosal break < 5mm found.

- Stomach: The gastric content is clear.
There is a subepithelial tumor 0.8cm in the high body.
There are shallow gastric ulcers over the antrum, status post CLO test.

- Duodenum: No remarkable mucosal lesion found.
5.
Anatomic extent of examination: Up to the second portion of the duodenum.
6.
Limitation of examination: Residual food debris and retching may impair appropriate observation.
7.
Complication: No immediate complications occurred.
8.
Endoscopic Diagnosis: (Details please see the description area)
(1) Reflux esophagitis LA Grade A
(2) Shallow gastric ulcers status post CLO test
(3) Gastric subepithelial tumor 0.8cm, suggest EUS correlation
9.
Specimen: Specimens for CLO test
10.
Pain Score: Pre-procedure: 0/10 Post-procedure: 3/10
11.
Immediate post-procedure needs: (1) Gastroenterology outpatient clinic for treatment and follow-up
Additionally, the test for Helicobacter pylori during the endoscopy showed negative results.
I would like to ask the following questions:
1.
The doctor who performed the examination advised me to wait three months before undergoing another endoscopy.
If I do not want to wait that long, can I proceed with direct removal?
2.
What is the likelihood that the gastric subepithelial tumor is malignant?
3.
If endoscopic surgery is required, how long would I need to be hospitalized?
I wanted to ask the doctor who performed the examination at that moment, but he kept insisting on just monitoring it and said that was enough.
I have been very worried after returning home, and there is not much information online.
I would appreciate your answers! Thank you for your help.

Nìmíng, 30~39 year old female. Ask Date: 2022/10/25

Dr. Cai Jinji reply Gastroenterology and Hepatology

Hello Miss Anonymous: It is advisable to confirm the diagnosis first before deciding on the course of action.
There are many possibilities for submucosal tumors of the stomach, and generally, the larger the tumor, the higher the chance of malignancy.
As for surgery, it will depend on the examination results to determine the best treatment approach.
If you have concerns, you may consult other physicians.
Director Cai Jin-ji, Department of Hepatobiliary and Gastroenterology, Nantou Hospital.

Reply Date: 2022/10/25

More Info

Understanding subepithelial tumors in the stomach can be a complex and concerning issue for many patients. Based on your recent endoscopic report, you have a subepithelial tumor measuring 0.8 cm located in the high body of the stomach, along with some shallow gastric ulcers. Here are answers to your key questions regarding this condition.

1. Can I opt for immediate removal instead of waiting for three months?
While it is understandable to feel anxious about the presence of a subepithelial tumor, the decision to proceed with immediate removal versus observation should be made in consultation with your gastroenterologist. The recommendation to wait for three months is likely based on the size of the tumor and the need for further evaluation, such as an endoscopic ultrasound (EUS), which can provide more information about the tumor's characteristics and depth of invasion. If you are uncomfortable with the wait, it is advisable to discuss your concerns with your doctor. They may consider your request for earlier intervention, but it is essential to weigh the risks and benefits of immediate surgery versus monitoring.

2. What is the likelihood that the subepithelial tumor is malignant?
The risk of malignancy in subepithelial tumors can vary significantly based on several factors, including the tumor's size, histological type, and growth pattern. Generally, smaller tumors (less than 1 cm) have a lower risk of being malignant. However, the only way to definitively determine the nature of the tumor is through histological examination, which may require a biopsy or surgical removal. Your gastroenterologist may recommend an EUS to assess the tumor's characteristics more thoroughly, which can help in determining the likelihood of malignancy.

3. How long would I need to stay in the hospital if I undergo endoscopic surgery?
The length of hospital stay after endoscopic surgery for a subepithelial tumor can vary based on several factors, including the complexity of the procedure, your overall health, and how well you recover post-operation. Generally, endoscopic procedures are minimally invasive, and many patients can go home the same day or after a short observation period. However, if complications arise or if the procedure is more extensive, a longer stay may be necessary. Your healthcare team will provide specific guidance based on your individual case.

In summary, while the presence of a subepithelial tumor can be concerning, it is crucial to follow your doctor's recommendations for monitoring and further evaluation. Engaging in open communication with your healthcare provider about your concerns and preferences is essential. They can help you understand the risks and benefits of different management strategies, including observation versus surgical intervention. Remember, each case is unique, and your doctor is best equipped to guide you based on your specific situation.

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