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Iijima Y, Tokumaru S, Kitazawa M, Nakamura S, Koyama M, Yamamoto Y, Ehara T, Hondo N, Miyazaki S, Soejima Y. Gastric glomus tumor resection using laparoscopic endoscopic cooperative surgery: A case report. Asian J Endosc Surg 2023. [PMID: 36592948 DOI: 10.1111/ases.13153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/25/2022] [Accepted: 12/03/2022] [Indexed: 01/04/2023]
Abstract
Gastric glomus tumors are rare submucosal mesenchymal neoplasms that are difficult to diagnose preoperatively. We present a case of a 60-year-old woman who was diagnosed with a gastric glomus tumor using endoscopic ultrasonography-guided fine-needle aspiration biopsy. The tumor was successfully resected with laparoscopic endoscopic cooperative surgery (LECS). LECS could be an effective method for the resection of gastric glomus tumors.
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Affiliation(s)
- Yasuhiro Iijima
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shigeo Tokumaru
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masato Kitazawa
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoshi Nakamura
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Makoto Koyama
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuta Yamamoto
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takehito Ehara
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Nao Hondo
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoru Miyazaki
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuji Soejima
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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Mehmood F, Jamil H, Khalid A. Gastric Glomus Tumor: A Rare Cause of Acute Blood Loss Anemia. Cureus 2022; 14:e24511. [PMID: 35651378 PMCID: PMC9135585 DOI: 10.7759/cureus.24511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 01/09/2023] Open
Abstract
Gastric glomus tumors (GGTs) are rare mesenchymal neoplasms that arise from cells of the glomus body. These occur in the submucosa of the gastric wall and are usually benign in nature. However, it is difficult to predict tumor behavior due to the lack of reliable histological features. Diagnosis can be challenging due to the lack of specific clinical features, and radiologic and endoscopic findings. Computed tomography (CT) scan, esophagogastroduodenoscopy (EGD), and endoscopic ultrasound (EUS) are key diagnostic modalities. However, the final diagnosis depends on the postoperative immunohistochemical and pathological analysis. Most GGTs can be cured by surgical or endoscopic resection. We report a case of GGT in a middle-aged woman who presented with new-onset anemia and was found to have a gastric mass that was later diagnosed as GGT after immunohistochemical staining.
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Wang WH, Shen TT, Gao ZX, Zhang X, Zhai ZH, Li YL. Combined laparoscopic-endoscopic approach for gastric glomus tumor: A case report. World J Clin Cases 2021; 9:7181-7188. [PMID: 34540976 PMCID: PMC8409180 DOI: 10.12998/wjcc.v9.i24.7181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/19/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastric glomus tumor (GGT) is rare submucosal mesenchymal tumor that lacks specific clinical manifestations and is usually treated mainly by traditional surgical resection. This paper presents a case of a GGT, exhibited both intraluminally and extraluminally growth that was removed by laparoscopy-gastroscopy cooperative surgery.
CASE SUMMARY A 52-year-old male presented with epigastric discomfort accompanied by a sense of fullness for 3 mo. Upper gastrointestinal endoscopy identified a submucosal lump located in the gastric antrum. Endoscopic ultrasonography identified a 2.4 cm × 1.8 cm lump located in the gastric antrum. It originated from the muscularis propria and exhibited both intraluminally and extraluminally growth, with hypoechoicity on the periphery, hyperechoicity in the middle, and unclear boundaries. Computed tomography showed nodular thickening of 3.0 cm × 2.2 cm in the gastric wall of the gastric antrum, and after enhancement, the lesion exhibited obvious enhancement We suspected that it was a gastrointestinal stromal tumor (glomus tumor and schwannoma were not excluded) and planned to perform laparoscopy-gastroscopy cooperative surgery. Immunohistochemical staining after the operation revealed that spinal muscular atrophy (+), h-caldesmon (+), cluster of differentiation 34 (CD34) (+), 2% Ki-67-positive rate, CD56, melanoma antigen, CD117, discovered on GIST-1, leukocyte common antigen, caudal type homeobox 2, cytokeratin, and S-100 were all negative. The tumor was finally diagnosed as a GGT.
CONCLUSION GGTs are rare submucosal tumors of the stomach and should be considered in the differential diagnosis of gastric submucosal tumors. Laparoscopy-gastroscopy cooperative surgery is less invasive and more precise and could be an effective method for the treatment of GGTs.
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Affiliation(s)
- Wen-Hao Wang
- Clinical Medical College, Weifang Medical University, Weifang 261042, Shandong Province, China
| | - Ting-Ting Shen
- Clinical Medical College, Weifang Medical University, Weifang 261042, Shandong Province, China
| | - Zhi-Xing Gao
- Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang 261042, Shandong Province, China
| | - Xin Zhang
- The Plastic Surgery Hospital of Weifang University, Weifang Medical University, Weifang 261042, Shandong Province, China
| | - Zhao-Hui Zhai
- Plastic Surgery Institute of Weifang Medical University, Yuhe Campus of Weifang Medical University, Weifang 261042, Shandong Province, China
| | - Yu-Li Li
- Plastic Surgery Institute of Weifang Medical University, Yuhe Campus of Weifang Medical University, Weifang 261042, Shandong Province, China
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Takagi T, Saito S, Yokota S, Kaneko Y, Takahashi K, Kanamaru R, Kurashina K, Hosoya Y, Kitayama J, Kawata H, Osawa H, Sata N. Laparoscopic and endoscopic cooperative surgery for leiomyosarcoma of the stomach: a case report with a review of the literature. Surg Case Rep 2021; 7:146. [PMID: 34143361 PMCID: PMC8212316 DOI: 10.1186/s40792-021-01218-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/26/2021] [Indexed: 11/12/2022] Open
Abstract
Background Leiomyosarcoma is a rare tumor that could originate from the gastrointestinal tract, uterus, kidney, retroperitoneum, and the soft tissues of the extremities. It accounts for only 1% of all gastrointestinal mesenchymal tumors and primary leiomyosarcoma of the stomach is extremely rare. Most cases reported as leiomyosarcoma of the stomach before the development of KIT immunohistochemistry might be gastrointestinal stromal tumors (GISTs) of the stomach and only 18 cases of leiomyosarcoma of the stomach have been reported since early 2000s. We report here a patient with leiomyosarcoma of the stomach treated by laparoscopic and endoscopic cooperative surgery (LECS). Case presentation A 59-year-old man was referred to our hospital for an early gastric cancer, which was initially treated by endoscopic submucosal dissection. Six months after his initial treatment, a follow-up esophagogastroduodenoscopy revealed a small polypoid lesion at the lesser curvature of the proximal stomach, which appeared to be a hyperplastic polyp. However, one and a half years later, the lesion grew and showed more irregular surface. Biopsy at the time revealed smooth muscle cell proliferation suggestive of leiomyoma. Three years later, the lesion grew even larger and biopsy showed pleomorphic spindle cells. Immunohistochemical study showed positive staining for alpha-smooth muscle actin and desmin, but negative for c-kit and CD34. Ki-67 labeling index was nearly 60%. Based on these findings, the diagnosis of leiomyosarcoma was established. The patient subsequently underwent a partial gastrectomy by LECS. The patient is currently in good condition without recurrence or metastasis at 12 months after surgery. Conclusions Leiomyosarcoma of the stomach is extremely rare. This is the first report of leiomyosarcoma of the stomach treated by LECS. We could also follow its appearance change through endoscopic examination for 3 years.
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Affiliation(s)
- Toru Takagi
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Shin Saito
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
| | - Shinichiro Yokota
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.,Department of Surgery, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA, 1521, USA
| | - Yuki Kaneko
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Kazuya Takahashi
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Rihito Kanamaru
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Kentaro Kurashina
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Yoshinori Hosoya
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Joji Kitayama
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
| | - Hirotoshi Kawata
- Department of Pathology, Jichi Medical University, Shimotsuke, Japan
| | - Hiroyuki Osawa
- Department of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
| | - Naohiro Sata
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan
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Alsahwan AG, Alfaraj ZM, AlSafwani J, Bunaiyan AH, AlKhalifah RH, Al-Saba'a SA, Al-Momen SA, Aldolah Q. Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report. Int J Surg Case Rep 2021; 81:105802. [PMID: 33887847 PMCID: PMC8045044 DOI: 10.1016/j.ijscr.2021.105802] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Glomus tumors are rare neoplasms that aris-e from neuromyoarterial canal or glomus body. They are mainly found in the peripheral soft tissue, extremities and rarely developed inside the gastrointestinal tract. In the gastrointestinal tract, the stomach is the most common site for the development of glomus tumors, and most often found in the antrum. Usually, the symptoms of gastric glomus tumors are non specific i.e (abdominal pain, GI bleeding and/or perforation) and possibly discovered incidentally during upper GI endoscopy. CASE PRESENTATION This is a-56-year-old-male, presented to the emergency department with upper GI bleeding i.e (melena), and signs of shock (HR: 110; BP:80/60), Blood tests showed Hemoglobin level: 5 g/dl. Resuscitation was started with IV fluid and transfusion of 4 units of PRBCs. After resuscitation, He gave a 10 days history of passing black tarry stool, palpitation, headache, dizziness, easily fatigability, malaise, and colicky epigastric abdominal pain. His abdomen was soft, lax with no tenderness, there was fullness at the left upper quadrant. Upper GI endoscopy was performed that showed a large gastric ulcer with adherent clots, necrotic base and oozing at the proximal part of the greater curvature, after that the bleeding was managed with a heater probe and epinephrine injections. The histopathological examination of the biopsy revealed a spindle and epithelioid tumor with the top differential diagnosis being GIST, however other submucosal lesions cannot be excluded. After that, He underwent exploratory laparotomy and wedge resection of the tumor. The final histopathology showed a malignant glomus tumor. CLINICAL DISCUSSION Due to overlapping clinical and radiological features between glomus, GIST and other submucosal lesions, the histopathological examination is considered to be the gold standard for the diagnosis. Surgical resection with negative margin is the treatment of choice for gastric glomus tumors. CONCLUSION Although gastric glomus tumor is a rare entity and accounts for 1% of all gastric mesenchymal tumors, it should be considered in the differential diagnosis, since preoperative biopsy is difficult and overlapping features with other submucosal lesions. Surgical treatment is the preferred option for gastric glomus tumor and long-term follow-up is required due to high metastatic and recurrence rate in the malignant type.
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Affiliation(s)
| | - Zainab M Alfaraj
- Department of Internal Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jihad AlSafwani
- Department of General Surgery, Qatif Central Hospital, Qatif, Saudi Arabia
| | | | - Ridha H AlKhalifah
- Department of General Surgery, Qatif Central Hospital, Qatif, Saudi Arabia
| | | | - Sami A Al-Momen
- Department of Internal Medicine, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Qassim Aldolah
- Department of General Surgery, Qatif Central Hospital, Qatif, Saudi Arabia
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Abstract
Background Glomus tumors (GTs) are mesenchymal neoplastic lesions arising from the glomus bodies and generally occur in the fingers and toes. Gastrointestinal GTs are rare, and most of them originate from the stomach; however, GT arising from the duodenum is exceedingly rare. Case presentation A 68-year-old man was admitted due to abdominal pain. Endoscopy showed a round, smooth, elevated mass in the second portion of the duodenum with central ulceration. Abdominal contrast computed tomography showed a hypervascular tumor measuring 26 mm in diameter in the second portion of the duodenum, and pancreatic invasion was suspected. Endoscopic ultrasonography of the lesion confirmed a hypoechoic mass arising from the fourth layer of the duodenal wall. A biopsy was performed for central ulceration, and immunochemical studies showed positive results for smooth muscle actin (SMA) and negative results for S100, C-Kit, and CD34. Leiomyoma or gastrointestinal stromal tumor was suspected and pancreatoduodenectomy was performed. The specimen exhibited a vascular-rich tumor, 24 × 24 × 19 mm in size, with deep ulceration in the duodenum. Histological examination showed uniform small round cells with central nuclei and a pale cytoplasm (glomus cell) with perivascular proliferation. Immunochemical studies showed that the tumor was positive for SMA and collagen type IV, and negative for C-Kit, CD34, desmin, and S100. We diagnosed the tumor as a GT of the duodenum. Conclusion GTs of the duodenum are exceedingly rare, but should be considered in the differential diagnoses of duodenal submucosal lesions.
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Tamaki I, Hosoda Y, Sasano H, Sasaki Y, Kiyochi H, Taki Y, Komoto I. Primary pancreatic glomus tumor invading into the superior mesenteric vein: a case report. Surg Case Rep 2020; 6:279. [PMID: 33141292 PMCID: PMC7609672 DOI: 10.1186/s40792-020-01058-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 10/22/2020] [Indexed: 11/25/2022] Open
Abstract
Background Glomus tumors are subcutaneous tumors arising from glomus bodies, thermoregulatory components of the skin. These tumors could occur in visceral organs where glomus bodies are not normally present. Herein, we report a case of primary pancreatic glomus tumor with aggressive direct invasion into the superior mesenteric vein (SMV). To the best of our knowledge, this is the second case report of a glomus tumor arising in the pancreas. Case presentation A 46-year-old woman was referred to our hospital due to vomiting with epigastric and back pain. Dynamic-CT revealed a well-circumscribed hypervascular mass, measuring 37 mm in its maximal diameter involving the pancreatic head. Both CT and endoscopic ultrasonography (EUS) revealed direct invasion into the SMV and radiologically suspected tumor thrombus. Biopsy sample obtained by EUS-guided fine needle aspiration revealed proliferation of small cells, round-to-oval tumor cells with round nuclei and scant cytoplasm. A histological diagnosis of pancreatic neuroendocrine tumor, G1 was initially considered. Therefore, subtotal stomach-preserving pancreatoduodenectomy using Child-II reconstruction was subsequently performed. Her SMV was resected and reconstructed due to extensive tumor involvement. Subsequent histopathological analysis revealed solid tumor cells proliferation that comprised oval-shaped nuclei and scant cytoplasm around disorganized or slit-shaped vessels in hematoxylin–eosin-stained slides. Immunohistochemical analysis then demonstrated positive immunoreactivity for smooth muscle actin, vimentin, and CD34, but negative for chromogranin A, synaptophysin, CD56, and signal transducer and activator of transcription 6. Based on these histological findings of resected specimens, the lesion was subsequently diagnosed as a primary pancreatic glomus tumor harboring direct invasion into the SMV. Her postoperative course was uneventful and annual surveys for the following 4 years post-op detected no clinical signs of recurrence. Conclusions We report a very rare case of glomus tumor of the pancreas accompanied by venous invasion. Curative surgical resection is the best treatment option for pancreatic glomus tumors. Although pancreatic glomus tumor is rare, it should be taken into consideration in the differential diagnosis of a pancreatic solid tumor with hypervascularity.
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Affiliation(s)
- Ichiro Tamaki
- Department of Surgery, Kansai Electric Power Hospital, Fukushima 2-1-7, Fukushima-ku, Osaka City, Osaka, 553-0003, Japan
| | - Yohei Hosoda
- Department of Surgery, Kansai Electric Power Hospital, Fukushima 2-1-7, Fukushima-ku, Osaka City, Osaka, 553-0003, Japan
| | - Hironobu Sasano
- Graduate School of Medicine, Anatomic Pathology, Tohoku University, Sendai, Japan
| | - Yu Sasaki
- Department of Surgery, Kansai Electric Power Hospital, Fukushima 2-1-7, Fukushima-ku, Osaka City, Osaka, 553-0003, Japan
| | - Hidenori Kiyochi
- Department of Surgery, Kansai Electric Power Hospital, Fukushima 2-1-7, Fukushima-ku, Osaka City, Osaka, 553-0003, Japan
| | - Yoshiro Taki
- Department of Surgery, Kansai Electric Power Hospital, Fukushima 2-1-7, Fukushima-ku, Osaka City, Osaka, 553-0003, Japan
| | - Izumi Komoto
- Department of Surgery, Kansai Electric Power Hospital, Fukushima 2-1-7, Fukushima-ku, Osaka City, Osaka, 553-0003, Japan.
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Mavrogenis G, Mitropapas G, Kyriakidou V, Bazerbachi F. Laparoscopic endoscopic cooperative surgery for a gastric glomus tumor previously diagnosed by endoscopic ultrasound fine-needle biopsy. Ann Gastroenterol 2020; 33:219. [PMID: 32127744 PMCID: PMC7049236 DOI: 10.20524/aog.2019.0445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Georgios Mavrogenis
- Department of Gastroenterology, Mediterraneo Hospital, Athens, Greece (Georgios Mavrogenis)
| | | | - Vasiliki Kyriakidou
- Cytopathology, Hygeia & Mitera Hospital, Athens, Greece (Vasiliki Kyriakidou)
| | - Fateh Bazerbachi
- Gastroenterology, Massachusetts General Hospital, Boston, USA (Fateh Bazerbachi)
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The Role of Endoscopic Ultrasound and Endoscopic Resection for Gastric Glomus: A Case Series and Literature Review. J Transl Int Med 2019; 7:149-154. [PMID: 32010601 PMCID: PMC6985914 DOI: 10.2478/jtim-2019-0030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background and Objectives Preoperative diagnosis of gastric glomus tumor is very difficult, and there are few reports regarding the endoscopic treatment of glomus tumor of the stomach. Our aim is to provide a retrospective assessment of the imaging features of endoscopic ultrasound (EUS) and treatment of choice of gastric glomus tumor. Methods A database of all patients with gastric glomus tumor who was treated at Shengjing Hospital of China Medical University between March 2011 and March 2017 was retrospectively analyzed. The EUS characteristics and patients’ clinical data as well as their treatment were reviewed. At the same time, we compared EUS characteristics of gastric glomus tumor with that of gastrointestinal stromal tumor (GISTs), leiomyomas, schwannomas, and ectopic pancreas. Results Eleven patients (3 male and 8 female patients) were included in the present study. The patients’ age ranged from 37 to 62 years (mean age, 50.1 years). Ten patients received EUS examination. Eight lesions were presented with mild-hyperechoic round or oval mass; one lesion was mild-hyperechoic oval mass with hypoechoic spots; one lesion was hypoechoic oval mass. One patient received endoscopic full-thickness resection; 3 patients were treated by endoscopic submucosal dissection; and laparoscopic resection was performed for 7 patients. Conclusions Gastric glomus has typical EUS features to differentiate from other submucosal tumors. Compared with surgery, endoscopic resection is also a safe and effective treatment of choice for gastric glomus tumor.
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Urabe F, Miki J, Kimura T, Hisakane A, Iwatani K, Takahashi K, Yanagisawa T, Takahashi H, Kishimoto K, Egawa S. Combination of en bloc transurethral resection with laparoscopic partial cystectomy for paraganglioma of the bladder. IJU Case Rep 2019; 2:283-286. [PMID: 32743438 PMCID: PMC7292116 DOI: 10.1002/iju5.12102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/18/2019] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Paraganglioma of the bladder is an extremely rare tumor, and special attention should be paid to elevation of blood pressure during tumor resection. CASE PRESENTATION A 64-year-old woman presented with elevation of blood pressure during thoracic surgery. Multiparametric magnetic resonance imaging revealed a bladder tumor, and noradrenalin levels were elevated in plasma and urine. The tumor was surgically removed by en bloc transurethral resection with laparoscopic partial cystectomy of bladder tumor. The margin of the tumor was easily identified, and perioperative blood pressure was stable. There was no evidence of residual tumor, local recurrence, or distant metastasis during 2-year follow-up. CONCLUSION To our knowledge, we report the first case of paraganglioma of the bladder resected by a minimally invasive and safe procedure: combination of en bloc transurethral resection and laparoscopic partial cystectomy.
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Affiliation(s)
- Fumihiko Urabe
- Department of UrologyThe Jikei University Kashiwa HospitalKashiwaChibaJapan
- Department of UrologyThe Jikei University School of MedicineMinato‐kuTokyoJapan
| | - Jun Miki
- Department of UrologyThe Jikei University Kashiwa HospitalKashiwaChibaJapan
| | - Takahiro Kimura
- Department of UrologyThe Jikei University School of MedicineMinato‐kuTokyoJapan
| | - Akira Hisakane
- Department of UrologyThe Jikei University Kashiwa HospitalKashiwaChibaJapan
| | - Kosuke Iwatani
- Department of UrologyThe Jikei University Kashiwa HospitalKashiwaChibaJapan
| | - Kazuhiro Takahashi
- Department of UrologyThe Jikei University Kashiwa HospitalKashiwaChibaJapan
| | | | - Hiroyuki Takahashi
- Department of PathologyThe Jikei University School of MedicineMinato‐kuTokyoJapan
| | - Koichi Kishimoto
- Department of UrologyThe Jikei University Kashiwa HospitalKashiwaChibaJapan
| | - Shin Egawa
- Department of UrologyThe Jikei University School of MedicineMinato‐kuTokyoJapan
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Abstract
RATIONALE Glomus tumors (GTs) are a rare disorder originating from the glomus of the anastomoses of small arteries, usually occurring in the subungual region of the fingertips or toes and seldom occurring in the stomach. We unintentionally found a case of a gastric glomus tumor (GGT) without any upper abdominal discomfort. The diagnosis of this disease was mainly by immunohistochemistry. PATIENT CONCERNS The patient presented to our hospital with intermittent right abdominal pain for 1 month. Abdominal computed tomography showed a nodular enhancement lesion in the gastric antrum. DIAGNOSES The patient was diagnosed with an ileocecal tumor and a gastric stromal tumor. INTERVENTIONS Surgical resection of the ileocecal and gastric tumors was performed. OUTCOMES Pathologic examination of gastric masses revealed GT. The operation was effective, and the patient was discharged from our hospital 7 days after surgery. Upon follow-up at 3 months, the patient was asymptomatic. LESSONS GTs are submucosal tumors rarely found in the stomach. Surgical resection is a good choice of treatment. The GGT lacked specific clinical and imaging features, and immunohistochemistry was essential in the diagnosis of GGT.
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Affiliation(s)
- Menghui Wu
- Department of Gastric and Colorectal Surgery, The First Hospital of Jilin University
| | - Tianyu Zhou
- Department of Gastric and Colorectal Surgery, The First Hospital of Jilin University
| | - Donghui Cao
- Department of Clinical Research, The First Hospital of Jilin University
| | - Limei Qu
- Department of Pathology, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xueyuan Cao
- Department of Gastric and Colorectal Surgery, The First Hospital of Jilin University
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Saito S, Yan C, Fukuda H, Hosoya Y, Matsumoto S, Matsubara D, Kitayama J, Lefor AK, Sata N. Synchronous gastric leiomyoma and intramuscular abdominal wall granular cell tumor with similar imaging features: A case report. Int J Surg Case Rep 2018; 44:207-211. [PMID: 29529541 PMCID: PMC5928285 DOI: 10.1016/j.ijscr.2018.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 03/04/2018] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Gastric leiomyomas are benign mesenchymal tumors, comprising about 2.5% of gastric neoplasms, which can be difficult to differentiate from gastrointestinal stromal tumors which have malignant potential. Granular cell tumors in the abdominal wall are also rare. Since mesenchymal tumors are difficult to diagnose by imaging, further studies are needed to establish the diagnosis. PRESENTATION OF CASE A 60-year-old asymptomatic woman underwent routine upper endoscopy and was found to have a gastric submucosal lesion. Computed tomography scan also showed an abdominal wall mass. The appearance of both lesions on imaging studies were similar, but it was unclear if the two lesions had the same origin. Endoscopic ultrasound-guided fine needle aspiration biopsy of the gastric lesion was insufficient to establish the diagnosis. Laparoscopic-endoscopic cooperative resection of the gastric lesion and ultrasound-guided core-needle biopsy of the abdominal wall mass enabled pathological diagnosis of both lesions. DISCUSSION Diagnostic imaging findings of these two lesions were similar. Histologic and immunohistochemical studies are essential to establish a definitive diagnosis. Laparoscopic-endoscopic cooperative surgery may be an effective minimally invasive approach, allowing both pathological diagnosis and complete resection of a gastric submucosal tumor, especially when endoscopic-ultrasound guided fine needle aspiration or biopsy fails to make the diagnosis. CONCLUSION Laparoscopic-endoscopic cooperative surgery can be an effective minimally invasive approach to resect some lesions. This is first report of the patient with a synchronous gastric leiomyoma and an intramuscular granular cell tumor in the abdominal wall.
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Affiliation(s)
- Shin Saito
- Departments of Surgery, Jichi Medical University, Tochigi, Japan.
| | - Chao Yan
- Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China
| | - Hisashi Fukuda
- Departments of Gastroenterology, Jichi Medical University, Tochigi, Japan
| | - Yoshinori Hosoya
- Departments of Surgery, Jichi Medical University, Tochigi, Japan
| | - Shiro Matsumoto
- Departments of Surgery, Jichi Medical University, Tochigi, Japan
| | | | - Joji Kitayama
- Departments of Surgery, Jichi Medical University, Tochigi, Japan
| | | | - Naohiro Sata
- Departments of Surgery, Jichi Medical University, Tochigi, Japan
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