Zusammenfassung
Endoskopie und Endosonographie haben v. a. bei kleinen inzidentellen gastrointestinalen Stromatumoren (GIST) des Magens in der Diagnostik und bei der Festlegung des weiteren Procedere einen hohen Stellenwert. In dieser Übersichtsarbeit werden zunächst die technischen Aspekte und Einsatzmöglichkeiten der Endoskopie und Endosonographie, einschließlich endoskopischer Probengewinnung und Resektion, sowie deren Limitationen bei der Diagnostik von GIST erläutert. Nachfolgend werden das Vorkommen und die endosonographische Differenzialdiagnose von GIST beschrieben. Den Schwerpunkt des Artikels bildet eine datenbasierte Darstellung des gegenwärtig empfohlenen diagnostisch-therapeutischen Vorgehens bei Verdacht auf kleine GIST unter Berücksichtigung der European-Society-of-Medical-Oncology- (ESMO-)Leitlinien. Abschließend werden kurz die begrenzten Möglichkeiten der endoskopischen Behandlung von GIST-Komplikationen (Blutung, Stenose) und die Bedeutung der Endoskopie und Endosonographie für die weiterführende Diagnostik von bereits schnittbildtechnisch geäußertem Verdacht auf GIST skizziert.
Abstract
Endoscopy and endoscopic ultrasonography (EUS) are important diagnostic tools for the diagnosis of gastrointestinal stromal tumors (GIST), especially for small incidental GISTs of the stomach and are necessary to make a decision for further procedures. In this overview the technical aspects and the use of endoscopy and EUS in the diagnosis of GIST, including endoscopic probe sampling and resection as well as the current limitations are described. The incidence of GIST and the differential diagnosis by endosonography are also described. This article concentrates on the data based description of the current diagnostic and therapeutic recommendations in suspected small GISTs with respect to the European Society of Medical Oncology (ESMO) guidelines. Finally, the limited options of endoscopic treatment of GIST complications (bleeding, stenosis) and the significance of endoscopy and EUS in further diagnosis of GIST which had been suspected from radiological imaging are briefly discussed.
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Szukics, B., Wagner, A. Endoskopische und endosonographische Diagnostik gastrointestinaler Stromatumoren. Radiologe 49, 1117–1121 (2009). https://doi.org/10.1007/s00117-009-1851-x
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DOI: https://doi.org/10.1007/s00117-009-1851-x
Schlüsselwörter
- Gastrointestinale Stromatumoren (GIST)
- Subepitheliale Raumforderung
- Endosonographie
- Endosonographische Feinnadelaspiration (EUS-FNA)
- ESMO- (European-Society-of-Medical-Oncology-)Leitlinien