7054 The diagnostic value of endoprobe by continuous water infusion method for esophageal leiomyomas derived from the muscularis mucosae.

Abstract

Backgrounds: Esophageal leiomyomas derived from the muscularis mucosae(MM) are verv rare, and has still much debate about the best modality for diagnosis and treatment. Endoscopic ultrasonogrphy can provide an accurate image of layer structure of the esophagus and information whether the lesion is suitable for endoscopic therapy or not. Aims: This clinical study was carried out to investigate the diagnostic value of a transendoscopic balloon-tipped miniature ultrasonic probe(USP) by continuous water infusion method for esophageal leiomyomas derived from MM.Methods:We resected 7 esophageal leiomyomas derived from MM by endoscopic mucosal resection(EMR), all of which were diagnosed by balloon-tipped USP. Olympus UM-2R and UM-3R(12 and 20 MHz) USP with balloon-tipped catheter MH-246R were used. The water was infused continuously by Olympus UWS-1 water supply unit during the ultrasonic examination. The endosonographic and pathologic features on 7 cases of esophageal leiomyomas derived from MM were compared. Results: Balloon-tipped USP clearly showed all 7 esophageal leiomyomas derived from MM, even less than 5 mm in size(the smallest lesion was 3.0 mm in size). The endosonographic characteristics of esophageal leiomyomas derived from MM were hypoechoic mass with smooth, regular, and well defined outer margin and homogenous inner echogram arising from the second hypoechoic layer. Complete resections were possible in all 7 cases by EMR, and no complications occurred after EMR. Tumor size was 3.0- 13.5 mm(mean 7.8 mm) in maximum diameter. In all cases, endosonogrphic finding by USP were exactly concordant with pathologic finding in determining the tumors depth in the esophageal wall, tissue origin and characteristics, growth pattern, and size. Conclusions:The balloon-tipped USP by continuous water infusion method is easy, convenient, and very useful in making correct diagnosis of esophageal leiomyomas derived from MM and appropriate applications of EMR.