Review Article
Volume 7 Issue 9 - 2020
Current Guidelines in the Diagnosis and Management of Gastric Subepithelial Tumors
Elleuch Nour*, Soumaya Mrabet, Aya Hammami, Hanen Jaziri, Aida Ben Slama, Ajmi Salem, Brahim Ahlem, Ksiaa Mehdi and Jmaa Ali
Department of Gastroenterology, Sahloul Hospital Sousse, University of Sousse, Tunisia
*Corresponding Author: Elleuch Nour, Department of Gastroenterology, Sahloul Hospital Sousse, University of Sousse, Tunisia.
Received: April 19, 2020; Published: August 18, 2020


Gastric subepithelial tumors (GSETs) are frequently asymptomatic and found by endoscopic examinations as protuberant lesions or bumps covered with intact mucosa. They are classified in epithelial and non-epithelial tumors (benign or malignant lesions). Among the mesenchymal tumors, gastrointestinal stromal tumors (GISTs) are the most frequent. The diagnostic strategy is based on endoscopic, radiological and cytological examinations. Endoscopic ultrasonography (EUS) is the key exam for eliminating extraluminal compressions, for presumptive diagnosis and clinical management of GSETs. Cytological or biopsy specimens, which can be performed during EUS, are indicated when the diagnosis cannot be specified by EUS. Therapeutic approach to GSETs depends on their histology first, their size secondly and finally on the presence or not of specific symptoms. The management may be very different according to the lesion, from abstention to endoscopic or surgical resection requiring a precise pretreatment assessment.

Keywords: Subepithelial Tumors (SETs); Gastric Subepithelial Tumors (GSETs); Endoscopic Ultrasonography (EUS)


  1. Jin Woong C and the Korean ESD Study Group. “Current guidelines in the management of upper gastrointestinal subepithelial tumors”. Clinical Endoscopy 49 (2016): 235-240.
  2. Wiech T., et al. “Histopathological classification of nonneoplastic and neoplastic gastrointestinal submucosal lesions”. Endoscopy 37 (2005): 630-634.
  3. Yoshiko N., et al. “Reasons for diagnostic failure in forty-five consecutive mucosal cutting biopsy examinations of gastric subepithelial tumors”. Clinical Endoscopy (2020). 
  4. Nishida T., et al. “Submucosal tumors: Comprehensive guide for the diagnosis and therapy of gastrointestinal submucosal tumors”. Digestive Endoscopy 25 (2013): 479-489.
  5. Dumonceau JM., et al. “Indications, results and clinical impact of endoscopic ultrasound guided sampling in Gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE)” (2017).
  6. L Faulx A., et al. “The role of endoscopy in subepithelial lesions of the GI tract”. Gastrointestinal Endoscopy (2017). 
  7. Sang Yoon Kim., et al. “Comparison of the Diagnostic Ability of Endoscopic Ultrasonography and Abdominopelvic Computed Tomography in the Diagnosis of Gastric Subepithelial Tumors”. Clinical Endoscopy 52 (2019): 565-573.
  8. Ikehara H., et al. “Histological diagnosis of gastric submucosal tumors: A pilot study of endoscopic ultrasonography-guided fine-needle aspiration biopsy vs mucosal cutting biopsy”. World Journal of Gastrointestinal Endoscopy 7.14 (2015): 1142-1149.
  9. Kataoka M., et al. “Mucosal cutting biopsy technique for histological diagnosis of suspected gastrointestinal stromal tumors of the stomach”. Digestive Endoscopy 25 (2013): 274-280.
  10. Rong L., et al. “Factors affecting the diagnostic accuracy of endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) for upper gastrointestinal submucosal or extraluminal solid mass lesions”. Digestive Endoscopy 24 (2012): 358-363.
  11. Azuma M., et al. “Diagnostic potential of endoscopic ultrasonography-elastography for gastric submucosal tumors”. Digestive Endoscopy 27.1 (2015): 23.
  12. Lau S., et al. “Imaging of gastrointestinal stromal tumour (GIST)”. Clinical Radiology 59 (2004): 487-498.
  13. Ponsaing LG., et al. “Diagnostic procedures for submucosal tumors in the gastrointestinal tract”. World Journal of Gastroenterology 13 (2007): 3301-3310.
  14. Wiech T., et al. “Histopathological classification of nonneoplastic and neoplastic gastrointestinal submucosal lesions”. Endoscopy 37 (2005): 630-634.
  15. Kazuya Akahoshi., et al. “Current clinical management of gastrointestinal stromal tumor”. World Journal of Gastroenterology 24.26 (2018): 2806-2817.
  16. ESMO/European Sarcoma Network Working Group. “Gastrointestinal stromal tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up”. Annals of Oncology 25.3 (2014): iii21-iii26.
  17. Su Young Kim and Kyoung Oh Kim. “Management of gastric subepithelial tumors: The role of endoscopy”. World Journal of Gastrointestinal Endoscopy 8.11 (2016): 418-424.
  18. Jin Woong Cho and the Korean ESD Study Group. “Current Guidelines in the Management of Upper Gastrointestinal Subepithelial Tumors”. Clinical Endoscopy 49.3 (2016): 235-240.
  19. PG Casali., et al. “Gastrointestinal stromal tumours: ESMO–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up”. Annals of Oncology 29 (2018): 68-78.
Citation: Elleuch Nour., et al. “Current Guidelines in the Diagnosis and Management of Gastric Subepithelial Tumors”. EC Gastroenterology and Digestive System 7.9 (2020): 62-68.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

July Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the July issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before July 18, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.