In their study, to differentiate GISTs from leiomyomas by EUS, the following four features were helpful; inhomogenicity, hyperechogenic spots, a marginal halo and higher echogenicity as compared with the surrounding muscle layer. These features appeared more frequently in GISTs than in leiomyomas. The presence of at least two of these four features had a sensitivity of 89.1% and a specificity of 85.7% for predicting GISTs.
Except for tumor size and irregularity of the border, most of the EUS features were not helpful in predicting the malignant potential of GISTs. On multivariate analysis, only the maximal diameter of the GISTs was an independent predictor. The optimal size for predicting malignant GISTs was 35 mm. The sensitivity and specificity using this value were 92.3% and 78.8%, respectively.Gastric mesenchymal tumors are often asymptomatic, and they are usually incidentally discovered during upper gastrointestinal endoscopy for unrelated conditions.
The main problem in the asymptomatic patient is to determine whether or not the tumors have a malignant potential. Because GISTs have malignant potential, gastric mesenchymal tumors, even if they are small, should not be ignored if the EUS features are suggestive of GISTs. Even though, there are already a large number of publications on the EUS-features of stromal cell tumors available, this research would provide an additional clinical approach guideline in patients with gastric mesenchymal tumors.