A Case of Eosinophilic Granuloma Presenting as a Small Submucosal Tumor

Routine screening esophagogastroduodenoscopy in an asymptomatic woman over 40 years of age revealed a small submucosal tumor with a yellowish appearance in the antrum (Picture 1, 2). On endoscopic ultrasonography, a lowechoic mass with a clear border involving the deeper side of the mucosa to the submucosa was visualized. In the differential diagnosis, the possibility of a neuroendocrine tumor was considered (Picture 3). The tumor diameter was <10 mm, therefore, for a total biopsy, endoscopic submucosal dissection (ESD) was performed after obtaining informed consent (1). The pathological findings suggested an eosinophilic granuloma related to gastric anisakiasis (Picture 4). Chronic anisakiasis is considered to be a topical change in the response to foreign bodies at the time of initial infection and is asymptomatic in most cases (2). This is a rare case of ESD for a submucosal tumor related to a gastric eosinophilic granuloma required for distinguishing a neuroendocrine tumor.