A case report of diffuse submucosal cysts of the stomach with gastric ulcer

A 74-year old male with a chief compliant of epigastralgia was admitted to our hospital for further examination. The x-ray and endoscopic examination of the stomach reveled gastric ulcer of the gastric angle and submucosal tumor (SMT) in the gastric antrum. Endoscopic ultrasonography (EUS) of the SMT showed thickening of the third layer in which well-difined, round and anechoic areas were gathered. They were thought to be cystic lesions. The image of EUS was identified by the endoscopic mucosal resection (EMR) taken from the SMT, which microscopically showed many pyloric glands with cystic dilatation in the submucosa and many smooth muscle bundles around cysts. Furthermore, EUS in the gastric body and the cardia which were free of swelling folds reveled cysts sporadically arising from the 3rd layer. The diagnosis was made based on the findings from EUS and EMR. Thus, EUS and EMR are thought to be very useful for the diagnosis of the diffuse submucosal cysts of the stomach.