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Singh S, Kumar A, Singh V. Gastric Glomus Tumor. Niger J Surg 2020; 26:162-165. [PMID: 33223817 PMCID: PMC7659754 DOI: 10.4103/njs.njs_8_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 10/21/2019] [Accepted: 12/16/2019] [Indexed: 12/15/2022] Open
Abstract
This case report describes glomus tumor of the stomach, a rare entity, which is a mesenchymal origin tumor. They are generally benign and account for nearly 1% of all gastrointestinal (GI) soft-tissue tumors. They are almost impossible to diagnose preoperatively because of the lack of specific characteristics and are often mistaken for GI stromal tumors (GISTs). In our hospital setup, a female aged 24 years, presented with right lumbar abdominal pain which after a thorough workup leads to the preoperative diagnosis of GIST, and distal gastrectomy with Roux-en-y anastomosis was done. However, pathological and immunohistochemical findings done after the surgery were found consistent with the diagnosis of gastric glomus tumor. Discovered on GIST-1 (DOG-1) nonreactivity is considered for the diagnosis of glomus tumor which helps in excluding the diagnosis of GIST, which is positive for DOG-1. Hence, it was concluded that differential diagnosis on the basis of immunohistochemical findings can lead to an accurate preoperative diagnosis and further targeted surgical intervention.
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Affiliation(s)
- Sumitoj Singh
- Department of General Surgery, Government Medical College, Amritsar, Punjab, India
| | - Ashok Kumar
- Department of General Surgery, Government Medical College, Amritsar, Punjab, India
| | - Vikas Singh
- Department of General Surgery, Government Medical College, Amritsar, Punjab, India
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2
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Toti L, Manzia TM, Roma S, Meucci R, Blasi F, Ferlosio A, Tisone G, Orlacchio A. Rare malignant glomus tumor of the stomach with liver metastases. Radiol Case Rep 2019; 14:463-467. [PMID: 30766648 PMCID: PMC6360248 DOI: 10.1016/j.radcr.2019.01.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 02/08/2023] Open
Abstract
We report a case of a 72-year-old male admitted in our Unit with anemia and a 10 cm liver neoplasm. Computed tomography scan showed 2 lesions respectively in the II, III and, VIII segment of the liver. Surgical resection of the larger liver mass was performed and the tumor appeared as a solid-cystic mass and a diagnosis of malignant mesenchymal tumor not otherwise specified, was made. One month later a Computed tomography scan detected a dishomogeneous gastric mass, 6 cm in diameter, in the greater curvature, confirmed by esophagogastroduodenoscopy. The pathological diagnosis from endoscopic biopsy revealed a mesenchymal tumor requiring surgical removal for accurate diagnosis. The patient underwent relaparotomy and gastric resection and the pathological findings gave a diagnosis of a rare malignant glomic tumor of the stomach confirmed by the revision of previously performed hepatic resection classified as secondary lesion.
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Affiliation(s)
- Luca Toti
- Department of Surgery, Liver Unit also University Hospital Tor Vergata, Rome, Italy
| | - Tommaso Maria Manzia
- Department of Surgery, Liver Unit also University Hospital Tor Vergata, Rome, Italy
| | - Silvia Roma
- Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Rome 00133, Italy
| | - Rosaria Meucci
- Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Rome 00133, Italy
| | - Francesca Blasi
- Department of Surgery, Liver Unit also University Hospital Tor Vergata, Rome, Italy
| | - Amedeo Ferlosio
- Anatomic Pathology, University Hospital Tor Vergata, Rome, Italy
| | - Giuseppe Tisone
- Department of Surgery, Liver Unit also University Hospital Tor Vergata, Rome, Italy
| | - Antonio Orlacchio
- Department of Diagnostic and Interventional Radiology, University Hospital Tor Vergata, Rome 00133, Italy
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3
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Yıldız P, Gücin Z, Arıcı DS, Malya FÜ, Baysal B. Glomus tumor of the stomach. Turk J Surg 2018; 34:62-64. [PMID: 29756111 DOI: 10.5152/turkjsurg.2017.3169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/20/2015] [Indexed: 11/22/2022]
Abstract
Glomus tumor is a rare benign mesenchymal neoplasm derived from the glomus body, an arteriovenous shunt mainly located in dermis and subcutis. The most common localization of this tumor is extremities, especially nailbed. Glomus tumor in the gastrointestinal system is a rare condition. Here we report a gastric glomus tumor to raise awareness of this tumor and show the difficulties in the diagnosis.
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Affiliation(s)
- Pelin Yıldız
- Department of Pathology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey
| | - Zuhal Gücin
- Department of Pathology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey
| | - Dilek Sema Arıcı
- Department of Pathology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey
| | - Fatma Ümit Malya
- Department of General Surgery, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey
| | - Birol Baysal
- Department of Gastroenterology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey
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4
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Abstract
Gastric glomus tumors are rare, mesenchymal neoplasms, generally described as benign and account for nearly 1% of all gastrointestinal soft tissue tumors. The most common gastrointestinal site of involvement is the stomach, particularly the antrum. Gastric glomus tumors are submucosal tumors that lack specific clinical and endoscopic characteristics, and are often mistaken for the more common gastrointestinal stromal tumors. A 62-year-old Caucasian female presented with shortness of breath and a persistent cough. Clinical workup revealed a mass in the upper abdomen. After endoscopic ultrasound and fine needle aspiration raised concerns for cancer, the patient elected to proceed with exploratory laparotomy. A local resection was performed at the time of surgery. Pathologic and immunohistochemical findings following surgical resection were consistent with a gastric glomus tumor. Consideration of gastric glomus tumors in the differential diagnosis may optimize the chance for a more accurate preoperative diagnosis and targeted surgical intervention.
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Affiliation(s)
| | | | - Renato G Albaran
- Crittenton Hospital Medical Center, Rochester Hills, MI 48307, USA
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5
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Oruç MT, Çakir T, Aslaner A, Çekiç S, Sakar A, Yardimci EC. Incidental gastric glomus tumor after laparoscopic sleeve gastrectomy. AUTOPSY AND CASE REPORTS 2016; 6:47-50. [PMID: 27284541 PMCID: PMC4880434 DOI: 10.4322/acr.2016.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/10/2016] [Indexed: 11/30/2022] Open
Abstract
Gastric glomus tumors (GGTs) are unusual benign, subepithelial, mesenchymal neoplasms of modified smooth muscle cells representing a neoplastic counterpart of glomus bodies. A 38-year-old woman was admitted to our clinic presenting morbid obesity. Routine preoperative evaluations, such as laboratory analysis, abdominal ultrasonography, and upper gastrointestinal endoscopy, were performed. She underwent a classical laparoscopic sleeve gastrectomy (LSG). The postoperative course was uneventful and she was discharged for outpatient control. Her histopathology report revealed a GGT 0.8 cm in diameter. No further treatment was done and she had lost 28 kg at the postoperative sixth month. Here, we present the case of GGT, which was diagnosed incidentally after LSG.
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Affiliation(s)
- Mehmet Tahir Oruç
- Department of General Surgery - Antalya Training and Research Hospital, Antalya - Turkey
| | - Tuğrul Çakir
- Department of General Surgery - Antalya Training and Research Hospital, Antalya - Turkey
| | - Arif Aslaner
- Department of General Surgery - Antalya Training and Research Hospital, Antalya - Turkey
| | - Sema Çekiç
- Department of Pathology - Antalya Training and Research Hospital, Antalya - Turkey
| | - Alkan Sakar
- Department of General Surgery - Antalya Training and Research Hospital, Antalya - Turkey
| | - Erdem Can Yardimci
- Department of General Surgery - Antalya Training and Research Hospital, Antalya - Turkey
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6
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Gastric Glomus Tumor: A Rare Cause of Upper Gastrointestinal Bleeding. Case Rep Surg 2015; 2015:193684. [PMID: 26697255 PMCID: PMC4678096 DOI: 10.1155/2015/193684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 11/22/2015] [Indexed: 12/19/2022] Open
Abstract
A 24-year-old woman was referred to our department because of melena. These symptoms combined with severe anemia prompted us to perform an emergency upper endoscopy, which showed bleeding from an ulcerated 30 mm submucosal tumor in the gastric antrum. A computed tomography scan revealed a homogeneously enhanced mass, and endoscopic ultrasonography identified a well-demarcated mass in the third and fourth layers of the gastric wall. Because analysis of the possible medical causes remained inconclusive and the risk of rebleeding, laparoscopy-assisted gastric wedge resection was performed after administration of 10 units of red cell concentrate. Histological and immunohistological analysis revealed the tumor to be a gastric glomus tumor. Gastric submucosal tumors remain challenging to diagnose preoperatively as they show a variety of radiologic and clinicopathologic features and are associated with the risk of bleeding upon biopsy, as is indicated in the guidelines for gastric submucosal tumors. Gastric glomus tumors characteristically present with exsanguinating gastrointestinal hemorrhaging that often requires blood transfusion. Additionally, gastric submucosal tumors typically occur in elderly patients; however, this case involved a young patient who was 24 years old. Here, we describe this case in order to identify features that may aid in early differentiation of gastric submucosal tumors.
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Sahni T, Lipi L, Mishra P, Gajendra S, Sachdev R. Gastric Glomus Tumour: A Rare Cause of Gastrointestinal Bleeding. J Clin Diagn Res 2015; 9:EJ01. [PMID: 26557536 DOI: 10.7860/jcdr/2015/14097.6561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 06/24/2015] [Indexed: 11/24/2022]
Affiliation(s)
- Tushar Sahni
- Attending Consultant, Department of Pathology and Lab Medicine, Medanta - The Medicity , Gurgaon, Haryana, India
| | - Lipka Lipi
- Associate Consultant, Department of Pathology and Lab Medicine, Medanta - The Medicity , Gurgaon, Haryana, India
| | - Pankaj Mishra
- Senior Resident, Department of Pathology and Lab Medicine, Medanta - The Medicity , Gurgaon, Haryana, India
| | - Smeeta Gajendra
- Attending Consultant, Department of Pathology and Lab Medicine, Medanta - The Medicity , Gurgaon, Haryana, India
| | - Ritesh Sachdev
- Senior Consultant, Department of Pathology and Lab Medicine, Medanta - The Medicity , Gurgaon, Haryana, India
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8
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A rare submucosal tumour of stomach-glomus tumour: A case report. Int J Surg Case Rep 2015; 11:64-67. [PMID: 25935733 PMCID: PMC4446683 DOI: 10.1016/j.ijscr.2015.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 11/29/2022] Open
Abstract
Rare submucosal tumour of stomach. Incidence 1 in 100 gastrointestinal stromal tumour. Preoperative diagnosis is difficult. Immunohistochemistry gold standard tool for confirmation. Wedge resection is the treatment of choice.
Introduction Glomus tumour (GT) of the stomach is a rare submucosal mesenchymal tumour. Gastric glomus tumours are clinically recognized as benign. Nevertheless, some show biological behaviour similar to that of malignant lesions and presurgical confirmation is often impossible. Presentation of case A 32 year old female who presented with epigastric pain and was subsequently investigated for a antral tumour of the stomach and Wedge resection of tumour was done. Immunohistochemistry demonstrated strong positivity of smooth muscle actin and vimentin with low rate of mitosis studied by ki-67. Discussion We discuss the preoperative investigation, the diagnostic problems and the surgical treatment of the patient with gastric glomus tumour. Conclusion Glomus tumours should be considered as differential diagnosis for submucosal tumours of stomach.
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Jain SA, Agarwal L, Goyal A, Kumar R, Nadkarni S, Ameta A, Rao Ys A. Gastric glomus tumor. J Surg Case Rep 2014; 2014:rju049. [PMID: 24968870 PMCID: PMC4071341 DOI: 10.1093/jscr/rju049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/14/2014] [Accepted: 04/26/2014] [Indexed: 12/11/2022] Open
Abstract
Glomus tumors (GTs) are benign tumors originating from the glomus body which are usually solitary and small lesions. The vast majority are found in the distal extremities, particularly in the hand, wrist, foot and under the fingernails rarely involving visceral organs. Here we report a rare case of gastric GT presented to us with exsanguinating hematemesis and severe anemia. All the initial diagnostic tests were inconclusive. Contrast-enhanced computed tomography abdomen revealed a soft tissue density lesion within the first part of duodenum. Diagnostic laparotomy was planned and a mass of 3 × 2.5 × 2 cm was found at pylorus along greater curvature, without any evidence of lymphadenopathy or metastasis. Distal gastrectomy with gastrojejunostomy was done. Histopathology confirmed the diagnosis of a GT. Immunohistochemistry of tumor cells demonstrated smooth muscle actin and CD34 (very focal).
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Affiliation(s)
- Sumita A Jain
- Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Lakshman Agarwal
- Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Ashish Goyal
- Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Ranjan Kumar
- Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Shravan Nadkarni
- Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Atul Ameta
- Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Arjun Rao Ys
- Department of General Surgery, SMS Medical College, Jaipur, Rajasthan, India
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10
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Chen KB, Chen L. Glomus tumor in the stomach: A case report and review of the literature. Oncol Lett 2014; 7:1790-1792. [PMID: 24932234 PMCID: PMC4049669 DOI: 10.3892/ol.2014.1986] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 02/18/2014] [Indexed: 12/11/2022] Open
Abstract
This study reports a rare case of a 47-year-old female with a gastric glomus tumor who was admitted with epigastralgia. Endoscopic ultrasound revealed a protrusion on the posterior wall of the gastric antrum. Enhanced computed tomography confirmed the presence of a 10-mm mass. The tumor was resected, and immunohistochemistry revealed the tumor to be positive for smooth muscle actin and collagen type IV, and negative for synaptophysin, chromogranin A, laminin, S-100, cluster of differentiation (CD)34, CD31, CD99, cytokeratin (AE1/AE3), desmin and epithelial membrane antigen. The proliferation marker Ki-67 was positive in <5% of tumor cell nuclei. The clinical procedures with a review of the literature are reported.
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Affiliation(s)
- Kai-Bo Chen
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
| | - Li Chen
- Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310000, P.R. China
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