Midenin Benign Tümörleri
Özet
Mide tümörlerinin yaklaşık %7’sini oluşturan benign (iyi huylu) tümörler, midenin her tabakasından köken alabilir ve çoğunlukla antrum ile korpus bölgelerinde yerleşim gösterir. Bu lezyonlar epitelyal (hiperplastik, adenomatöz, inflamatuar polipler), non-epitelyal/submukozal (leiomyom, lipom, nörojenik tümörler, hemanjiyom) ve nöroendokrin tümörler olarak sınıflandırılır. Genellikle asemptomatik seyretmekle birlikte, ülserleşme eğilimleri nedeniyle epigastrik ağrı, gastrointestinal kanama, demir eksikliği anemisi ve pilor bölgesinde obstrüksiyona (tıkanma) yol açabilirler. Tanıda altın standart, gastroskopi ve histopatolojik değerlendirmedir. Hiperplastik polipler en sık görülen tür olup özellikle 1,5 cm'den büyük olanlarda malignite riski bulunduğundan snare polipektomi ile çıkarılmalıdır. Adenomatöz polipler ise %10-17 oranında mide kanserine dönüşme potansiyeline sahiptir ve tamamen eksize edilmelidir. Submukozal lezyonlar arasında en sık rastlanan leiomyomlar cerrahi eksizyon gerektirirken, lipom ve lenfangiom gibi diğer benign tümörlerin tanımlanmasında endoskopik ultrasonografi (EUS) kritik bir rol oynar. Tedavi yaklaşımları lezyonun boyutuna, histolojik yapısına ve semptomlara bağlı olarak endoskopik rezeksiyondan laparoskopik cerrahiye kadar değişiklik göstermektedir.
Benign stomach tumors account for approximately 7% of all gastric neoplasms, originating from various layers of the stomach, and are predominantly localized in the antrum and corpus. These lesions are classified into epithelial (hyperplastic, adenomatous, inflammatory polyps), non-epithelial/submucosal (leiomyoma, lipoma, neurogenic tumors, hemangioma), and neuroendocrine tumors. Although frequently asymptomatic, their tendency to ulcerate can cause epigastric pain, chronic bleeding, iron deficiency anemia, or gastric outlet obstruction particularly when located near the pylorus. Gastroscopy accompanied by histopathological evaluation remains the gold standard for definitive diagnosis. Hyperplastic polyps represent the most common type; however, due to a risk of malignant transformation in lesions larger than 1.5 cm, snare polypectomy is strongly recommended. Adenomatous polyps carry a significant 10-17% risk of progressing to gastric carcinoma, necessitating complete endoscopic or surgical excision. Among submucosal lesions, leiomyomas are the most prevalent and require surgical resection, whereas endoscopic ultrasonography (EUS) serves as a crucial diagnostic tool for identifying other benign tumors such as lipomas and lymphangiomas. Therapeutic management spans from endoscopic resection to laparoscopic wedge resection, determined by tumor size, histology, and clinical presentation.
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