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Abstract: Objective: To examine the values of endoscopic ultrasonography (EUS) on diagnosis and treatment of esophageal hamartoma. Methods: We compared and analyzed various kinds of imaging examinations such as barium esophagram, contrast-enhanced computed tomography (CT) and conventional gastroscopy in retrospectively reviewing the clinical data of an esophageal hamartoma patient seen in our clinic in the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Having received various imaging examinations, this patient was finally diagnosed with esophageal hamartoma and underwent gastroscopic resection of hamartoma with the diagnostic information obtained from EUS. The patient had been regularly followed up for 13 months after treatment. Results: Barium esophagram, CT and conventional gastroscopy detected the lesion, but were unable to distinguish it from common esophagopolypus and other submucosal lesions, and unable to determine etiopathogenisis. EUS detected the hamartoma and identified its internal structure, echo, exact size, depth of invasion, origin and the relationship between adjacent tissues and organs, differentiating the lesion from other submucosal tumors and clearly defining the diagnosis. EUS-guided fine needle aspiration (FNA) also helped to identify the etiological diagnosis. Conclusion: EUS was superior to other imaging means in diagnosis and treatment of hamartoma.

[1] Caletti, G., Ferrari, A., 1996. Endoscopic ultrasonography. Endoscopy, 28(3):156-158.

[2] Chen, T.K., Wu, C.H., Lee, C.L., Lai, Y.C., Yang, S.S., Tu, T.C., 2001. Endoscopic ultrasonography to study the causes of extragastric compression mimicking gastric submucosal tumor. J. Formos. Med. Assoc., 100(11):758-761.

[3] Dou, F.T., Liu, F.Z., 1996. Falsification polyposis syndrome: characteristics in clinic and radiology. Clinical Radiology of Abroad Medicine, 19(2):96-98 (in Chinese).

[4] Fusaroli, P., Caletti, G., 2005. Endoscopic ultrasonography: current clinical role. Eur. J. Gastroenterol. Hepatol., 17(3):293-301.

[5] Gress, F., Schmitt, C., Savides, T., Faigel, D.O., Catalano, M., Wassef, W., Roubein, L., Nickl, N., Ciaccia, D., Bhutani, M., et al., 2001. Interobserver agreement for EUS in the evaluation and diagnosis of submucosal masses. Gastrointest. Endosc., 53(1):71-76.

[6] Hoffman, A.L., Emre, S., Verham, R.P., Petrovic, L.M., Eguchi, S., Silverman, J.L., Geller, S.A., Schwartz, M.E., Miller, C.M., Makowka, L., 1997. Hepatic angiomyolipoma: two care reports of caudate-based lesions and review of the literature. Liver Transplantation and Surgery, 3(1):46-53.

[7] Hui, Y.Z., 2003. Chief Interpreter. Angiomyolipoma of Kidney. In: Sternberg, S.S. (Ed.), Diagnosis of Surgical Pathology (Next Volume), 3rd Ed. Medical Science Press of Peking University, Beijing, p.1812-1816 (in Chinese).

[8] Kevin, M.Z., Charis, E., 2007. Hamartomatous polyposis syndromes. Nature Clinical Practice Gastroenterology & Hepatology, 4(9):492-502.

[9] Kojima, T., Takahashi, H., Parrablanco, A., Kohsen, K., Fujita, R., 1999. Diagnosis of submucosal tumor of the upper GI tract by endoscopic resection. Gastrointest. Endosc., 50(4):516-522.

[10] Lanzafame, S., Massimino, O., 1989. Gastric carcinoma probably of hamartomatous orign. Presentation of a case and review of the literature. Pathologica, 81(1071):77-82 (in Italian).

[11] Liu, X., Zhou, Q.Z., Yu, Z.L., Zhang, S.T., 2006. Research advance of several hamartomatous polyp. Chinese Journal of Practical Internal Medicine, 26(9):663-664 (in Chinese).

[12] Rosch, T., Kapfer, B., Will, U., Baronius, W., Strobel, M., Lorenz, R., Ulm, K., 2002. Accuracy of endoscopic ultrasonography in upper gastrointestinal submucosal lesions: a prospective multicenter study. Scand. J. Gastroenterol., 37(7):856-862.

[13] Saito, H., Akahoshi, K., Oya, M., Kubokawa, M., Akiho, H., Sumida, Y., Fujimaru, T., Higuchi, N., Matsumoto, M., 2005. EUS-guided endoscopic resection using band ligation of oesophageal granular cell tumour: report of a case. Acta Gastroenterol. Belg., 68(2):272-275.

[14] Shen, E.F., Arnott, I.D.R., Plevris, J., Penman, I.D., 2002. Endoscopic ultrasonography in the diagnosis and management of suspected upper gastrointestinal submucosal tumours. British Journal of Surgery, 89(2):231-235.

[15] Song, X.D., Wang, W.Y., Tong, S.W., Wang, X.H., 2004. Enormous polypous esophageal hamartoma. Chinese Journal of Digestion, 24(12):744 (in Chinese).

[16] Sun, S.Y., Liu, J.G., 2006. The value of endoscopic ultrasonography on diagnosis of gastrointestinal stromal tumor. Chinese Journal of Practical Surgery, 26(8):578-580 (in Chinese).

[17] Takada, N., Higashino, M., Osugi, H., Tokuhara, T., Kinoshita, H., 1999. Utility of endoscopic ultrasonography in assessing the indications for endoscopic surgery of submucosal esophageal tumors. Surgical Endoscopy, 13(3):228-230.

[18] Utsunomiya, J., Gocho, H., Miyanaga, T., Hamaguchi, E., Kashimure, A., 1975. Peutz-Jeghers syndrome: its natural course and management. Johns. Hopkins. Med. J., 136(2):71-82.

[19] Wang, S.C., 1992. Thirty case reports of pulmonary hamartoma and analysis of domestic 477 cases. Chinese Journal of Surgery, 30(9):540-542 (in Chinese).

[20] Wu, G.H. (Ed.), 1993. Phymatology Dictionary, 1st Ed. People’s Hygiene Press of Peking, Beijing, p.30 (in Chinese).

[21] Xiong, Y., Yin, H.J., Zhang, Y., 2000. One case report of gastric hamartoma. Chinese Journal of Practical Internal Medicine, 20(10):599 (in Chinese).

[22] Xu, G.Q., Wu, Y.Q., Wang, L.J., Chen, H.T., 2008. Values of endoscopic ultrasonography for diagnosis and treatment of duodenal protruding lesions. J. Zhejiang Univ. Sci. B, 9(4):329-334.