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Brotherton T, Khneizer G, Nwankwo E, Yasin I, Giacaman M. Gastric Glomus Tumor Diagnosed by Upper Endoscopy. Cureus 2021; 13:e20703. [PMID: 35106240 PMCID: PMC8788387 DOI: 10.7759/cureus.20703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2021] [Indexed: 11/06/2022] Open
Abstract
Gastric glomus tumors (GGTs) are benign tumors that typically occur in the submucosa of the gastric wall. Glomus tumors typically occur in the subungual region of the finger and rarely manifest in the stomach. Diagnosis is challenging as these tumors lack specific clinical features, radiographic findings, and endoscopic findings. In prior cases, endoscopic ultrasound with fine-needle aspiration has been utilized to make a pre-operative diagnosis. In our case, pathology from general endoscopy was consistent with a GGT. Thus, our patient was accurately diagnosed by esophagogastroduodenoscopy (EGD) with conventional biopsy.
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2
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Pizzillo IA, Fang C, Sun W, Brandler TC. Gastric glomus tumor diagnosed by fine needle aspiration of the stomach: A report of two cases and review of the literature. Diagn Cytopathol 2021; 50:E100-E106. [PMID: 34870907 DOI: 10.1002/dc.24914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 11/10/2022]
Abstract
Glomus tumors make up 1% of stromal tumors of the stomach. Radiologic diagnosis of glomus tumors can be challenging as they share imaging characteristics with other neuroendocrine tumors and gastrointestinal stromal tumors. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been reported as a useful method for the evaluation of gastrointestinal lesions. We report two cases of gastric glomus tumors in which EUS-FNA diagnosis was challenging. Cytologically, neoplastic cells were round to oval, uniform, bland appearing epithelioid cells with delicate chromatin and inconspicuous to vague nucleoli. Both samples lacked worrisome features such as high nuclear grade, high mitotic rate, and necrosis. Neoplastic cells were negative for Cam5.2 and AE1/AE3 with focal expression of synaptophysin in one of the cases. A definitive diagnosis was not made based on FNA. Familiarity with glomus tumors in the GI system and procurement of adequate material for cell block allowing the use of immunohistochemistry may allow an accurate preoperative diagnosis.
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Affiliation(s)
- Isabella A Pizzillo
- Department of Pathology, NYU Grossman School of Medicine, New York, New York, USA
| | - Camila Fang
- Department of Pathology, NYU Grossman School of Medicine, New York, New York, USA
| | - Wei Sun
- Department of Pathology, NYU Langone Health, New York, New York, USA
| | - Tamar C Brandler
- Department of Pathology, NYU Langone Health, New York, New York, USA
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3
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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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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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5
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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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6
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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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7
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Mago S, Pasumarthi A, Miller DR, Saade R, Tadros M. The Two Challenges in Management of Gastric Glomus Tumors. Cureus 2020; 12:e9251. [PMID: 32821597 PMCID: PMC7430658 DOI: 10.7759/cureus.9251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Gastric glomus tumors (GGTs) are rare gastrointestinal lesions originating from the neuromuscular arterial canal or vascular lumen which share many overlapping features with other stromal lesions. Despite most cases of GGTs being benign, there is a lack of reliable histological features predictive of tumor behavior. We present a case of a 42-year-old male who was determined to have a GGT via histological diagnosis and underwent surgical wedge resection. This case highlights the importance of establishing an accurate diagnosis and the various factors that must be taken into consideration to best determine malignant potential and management options.
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Affiliation(s)
- Sheena Mago
- Internal Medicine, University of Connecticut Health Center, Farmington, USA
| | | | | | - Rayan Saade
- Pathology, Albany Medical Center, Albany, USA
| | - Micheal Tadros
- Gastroenterology and Hepatology, Albany Medical Center, Albany, USA
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8
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Marcella C, Shi R, Yu T, Sarwar S, Wang X, Liu Y. Asymptomatic esophageal glomus tumor: case report. J Gastrointest Oncol 2019; 10:1015-1020. [PMID: 31602340 DOI: 10.21037/jgo.2019.05.08] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Glomus tumor (GT) is one of the rarest gastrointestinal soft tissue neoplasms. GT in the esophagus has been scarcely reported, and only less than ten cases have been reported. Herein, we report another case of asymptomatic esophageal GT. A 30-year-old male patient was admitted due to incidental finding of esophageal mass on gastroscopy examination. Gastroscopy examination revealed an esophageal mass of 2.0 cm × 1.8 cm. Endoscopic ultrasound (EUS) showed a heterogeneous, hypoechoic mass originated from the submucosal layer and was adjacent to the thoracic aorta. The final diagnosis was confirmed by immunohistochemistry of smooth muscle actin (SMA), vimentin, caldesmon and focal positive of desmin, synaptophysin. The patient underwent submucosal tunneling endoscopic resection (STER) which was effective and the patient was discharged from our hospital 6 days after surgery. Upon 1 year of follow-up, no metastasis was observed. Esophageal GTs lacked specific manifestations and immunohistochemistry was crucial in diagnosis. Endoscopic treatment such as STER is a safe and effective method of treatment.
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Affiliation(s)
- Cicilia Marcella
- Department of Gastroenterology, Southeast University Affiliated Zhongda Hospital, Nanjing 210009, China
| | - Ruihua Shi
- Department of Gastroenterology, Southeast University Affiliated Zhongda Hospital, Nanjing 210009, China
| | - Ting Yu
- Department of Gastroenterology, Southeast University Affiliated Zhongda Hospital, Nanjing 210009, China
| | - Shakeel Sarwar
- Department of Orthopedics, Southeast University Affiliated Zhongda Hospital, Nanjing 210009, China
| | - Xueqin Wang
- Department of Pathology, Southeast University Affiliated Zhongda Hospital, Nanjing 210009, China
| | - Yang Liu
- Department of Gastroenterology, Southeast University Affiliated Zhongda Hospital, Nanjing 210009, China
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9
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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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10
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Masouminia M, Ghani HA, Foote D, Hari D, French S. Rare presentation of the glomus tumor in the stomach. Exp Mol Pathol 2017; 104:9-11. [PMID: 29221662 DOI: 10.1016/j.yexmp.2017.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 11/22/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Maryam Masouminia
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W Carson st, Torrance, CA 90502, United States
| | - Hassan Abdul Ghani
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W Carson st, Torrance, CA 90502, United States
| | - Dingle Foote
- Department of Radiology, Harbor-UCLA Medical Center, 1000 W Carson st, Torrance, CA 90502, United States
| | - Danielle Hari
- Department of Surgery, Harbor-UCLA Medical Center, 1000 W Carson st, Torrance, CA 90502, United States
| | - Samuel French
- Department of Pathology, Harbor-UCLA Medical Center, 1000 W Carson st, Torrance, CA 90502, United States.
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11
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Abstract
Glomus tumours are benign tumours typically arising from the glomus bodies and primarily found under the fingernails or toenails. These rare neoplasms account for <2% of all soft tissue tumours and are generally not found in the gastrointestinal tract. We report a case of a 40-year-old man presenting with recurrent epigastric pain and pyrosis. Endoscopy revealed a solitary tumour in the antrum of the stomach. Fine-needle aspiration biopsy was suspicious for a gastrointestinal stroma tumour. After CT indicated the resectability of the tumour, showing neither lymphatic nor distant metastases, a laparoscopic-assisted gastric wedge resection was performed. Surprisingly, histology revealed a glomus tumour of the stomach.
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Affiliation(s)
- Rebekka Troller
- Department of Surgery, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Christopher Soll
- Department of Surgery, Kantonsspital Winterthur, Winterthur, Switzerland
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12
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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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13
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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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14
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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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15
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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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16
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Abstract
Several unusual stomach tumors have been recently described. In addition, some tumors that are often encountered in other sites may rarely occur as primary gastric tumors. The diagnostic surgical pathologist needs to be aware of some of these lesions to prevent misdiagnosis. This overview discusses the key clinical features, pathology, immunohistochemistry, and relevant molecular findings of multiple minute gastrointestinal stromal tumors and interstitial cell of Cajal hyperplasia, nerve sheath tumors (schwannoma and perineurioma), gastroblastoma, granular cell tumor, glomus tumor, plexiform angiomyxoid myofibroblastic tumor, and primary clear cell sarcoma of the gastrointestinal tract that occur as primary gastric neoplasms.
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Affiliation(s)
- Lai Mun Wang
- Oxford University Hospitals Trust, University of Oxford, Oxford, UK
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17
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Glomus tumor of the stomach: a rare cause of upper gastrointestinal bleeding. Case Rep Surg 2011; 2011:371082. [PMID: 22606576 PMCID: PMC3350055 DOI: 10.1155/2011/371082] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 08/21/2011] [Indexed: 11/17/2022] Open
Abstract
Introduction. Glomus tumors (GTs) are benign neoplasm originating from the glomus body, commonly described in subungual region. The involvement abdominal is rare. Our aim is to describe a case of glomus tumor of the stomach that presented upper gastrointestinal bleeding. A 34-year-old woman was admitted with upper gastrointestinal bleeding and underwent an upper endoscopy that showed bleeding arising from an ulcerated lesion, treated by sclerosis therapy. A new endoscopy confirmed a submucosal lesion in upper portion of the stomach. During the laparotomy, a tumor at the upper anterior wall of gastric body was found and resected by a vertical gastrectomy. The pathological exam revealed hyperplastic smooth muscle fibers of the muscularis propria of the stomach wall, surrounded by hyaline stroma. The immunohistochemistry panel was positive for smooth muscle actin and type IV collagen, with low rate of mitosis studied by Ki-67 which allowed the final diagnosis of a gastric glomus tumor. Discussion. The majority of intraperitoneal glomus tumors occur in the stomach, and it is phenotypically similar to those localized in peripheral sites. Gastric GT generally is a benign tumor although it can be malignant and have the potential to metastasize. Conclusion. Even though gastric glomus tumor is rarely described, it should be considered as a possible cause of a major upper gastrointestinal bleeding.
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Abstract
AIM: To study the clinicopathological features of gastric glomus tumor and review the related Chinese literature published in 1990-2010.
METHODS: A case of gastric glomus tumor was reported. Clinicopathological findings in 56 cases of gastric glomus tumor were analyzed.
RESULTS: Gastric glomus tumor was far more common in women than in men with a female to male ratio of 1.6:1. The median age of the patients was 45 years (range 28-79 years). The patients often complained of epigastric pain and bloody stool. The tumor was located in antrum of the stomach. The greatest diameter of the tumor was 0.8-11cm. Histologically, the tumor was comprised of nests of glomus cells surrounding the capillaries. Glomus cells were small, uniform and round. Vimentin, smooth muscle actin and actin were expressed in the tumor. Other markers, including S-100 protein, CD34, CD117, desmin, CD56, synaptophysin, chromogranin A, neuron specific enolase and cytokeratin were all negative.
CONCLUSION: Gastric glomus tumor is a rare benign mesenchymal neoplasm. Its diagnosis depends on pathologic examination. Differential diagnosis includes gastrointestinal stromal tumor, paraganglioma and carcinoid tumor.
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