An Intraperitoneal Schwannoma Diagnosed Using EUS-guided Tissue Acquisition: A Marking Clip and Fluoroscopy Technique Ensuring Safety and Preventing Accidental Esophageal Puncture

A 41-year-old woman with a 20-mm intraperitoneal mass located beneath the gastric fundus and near the gastroesophageal junction safely underwent endoscopic ultrasound-guided tissue acquisition (EUS-TA) using a marking clip and fluoroscopic guidance. EUS revealed a hypoechoic lesion without continuity to the gastric wall close to the gastroesophageal junction. A clip was placed on the gastroesophageal junction, and EUS-TA with a 22-G Franseen needle was performed distal to the clip under fluoroscopy without complications. Histopathology confirmed a benign schwannoma, and surgery ensured complete removal. This technique allows safe EUS-TA near the gastroesophageal junction, thus mitigating the risk of esophageal perforation.