Gastric Glomus Tumor Research Articles

Glomus tumor in the stomach

Gastric glomus tumor is rare and most commonly described as a solitary, well-defined, submucosal lesion in the antrum with non-specific clinical manifestations. We report this case with representative image findings, correlate with clinical presentations and pathologic demonstrations that can help to early detect and distinguish it from other malignant tumors such as gastrointestinal stromal tumor.

Gastric Glomus Tumor

Gastric glomus tumors are rare submucosal lesions that originate from the modified smooth muscle cells of the glomus body. They usually present as a submucosal tumor on endoscopy and a heterogeneous hypoechoic tumor in the third or fourth sonographic layer of the gastric wall on endoscopic ultrasonography. So they are often confused with other submucosal tumors such as gastrointestinal stromal tumor, schwannoma, and leiomyoma. Immunohistochemistry helps in differentiating glomus tumors from other submucosal tumors. The treatment of choice for these tumors is complete surgical resection. Most of the gastric glomus tumors are essentially benign in nature, so preoperative recognition of this lesion may spare the patient a more extensive resection. Herein, we present three cases of gastric submucosal tumor that were treated by a laparoscopic wedge resection and confirmed as glomus tumor on final pathology. (J Korean Surg Soc 2009;77:S9-12)

Glomus tumor of the stomach

Gastric glomus tumors are rare neoplasms. We report here a case of gastric glomus tumor in a 25-year-old female who presented with exsanguinating gastrointestinal hemorrhage. Clinically and on gross examination, the tumor was suspected to be a gastrointestinal stromal tumor (GIST). Histopathological and immunohistochemical evaluation revealed it to be a glomus tumor.

Gastric Glomus Tumor

Purpose: Gastric glomus tumors are rare neoplasms originating from modified smooth muscle cells of glomus bodies. Glomus bodies are temperature sensitive neuromyoarterial receptors that help regulate arterial blood flow. We describe a rare occurrence of a patient with a gastric glomus tumor. Case: A 62 year old white man presented with a one month history of lower abdominal pain radiating to the back, exacerbated by bending or stooping. He complained of decreased appetite, nausea and vomiting, but denied weight loss, fever or chills. On physical exam he was afebrile and vital signs were normal. He was in obvious discomfort. Bowel sounds were normoactive. His abdomen was soft, tender over the RUQ. There was no obvious organomegaly or discrete mass. Labs revealed a WBC count 8.3 k/uL, Hgb 12.9 g/dL and platelets 361 k/uL. Amylase, lipase and complete metabolic panel were unremarkable except for albumin 2.8 g/dL and globulin 4.1 g/dL. CT abdomen without contrast showed a 2.8 cm mucosal mass near the anterior gastric body. Esophagogastroduodenoscopy (EGD) revealed a 3 cm submucosal mass with two small centrally located ulcers in the distal gastric body. Biopsies revealed atypical lymphoid infiltrate suspicious for a lymphoproliferative disorder. Repeat EGD with biopsies was unremarkable for flow cytometry; histology revealed gastric glomus tumor and chronic active H. pylori gastritis. Endoscopic ultrasound revealed an oval intramural (subepithelial) heterogeneous lesion originating from the muscularis propria (Layer 4) with well defined outer borders and an intact interface between the mass and adjacent structures, suggesting lack of invasion. Transgastric fine needle aspiration revealed a lesion infiltrated by round, uniform cells with moderate amounts of cytoplasm amid numerous large vessels. Immunostains were positive for muscle specific actin and vimentin and negative for leukocyte common antigen and chromagranin. Cytopathology and flow cytometry were unremarkable. A diagnosis of gastric glomus tumor and chronic active H. pylori gastritis was made. Laparoscopic excision of the 2.5 × 2.3 × 1.9 cm tumor was performed with free margins, three (0/3) negative perigastric lymph nodes and no evidence of vascular invasion. Pathology interpreted as glomus tumor of the stomach. Discussion: Although they may be located anywhere in the body, glomus tumors are most commonly found in the distal peripheral soft tissues of the fingers and toes. Gastric glomus tumors are rare, and generally considered benign solitary neoplasms. However, cases of multiple glomus tumors of the stomach and gastric glomus tumor with liver metastasis have been described and therefore, surgical resection is generally recommended. Methods: N/A Results: N/A Conclusion: N/A

Endoscopic Ultrasound-Guided Biopsy in Benign Disorders: FNA X Core Biopsy?

Background: Diagnosis of specific benign disorders through endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is often challenging to cytopathologists due to the lack of tissue architecture on cytological specimens. The use of a Trucut biopsy needle (TCB) may improve the diagnostic accuracy of benign conditions over EUS-FNA. Aim: To compare the diagnostic accuracy of EUS-FNA and EUS-TCB in benign lesions. Methods: From October 2003 to November 2006, all patients who were referred for EUS-guided biopsy with a final diagnosis of a benign condition and underwent both FNA and TCB were included. A benign diagnosis was established either by EUS core biopsy, surgical biopsy or extended clinical/imaging follow-up (>6 months). Cytology and histological specimens from the FNA and TCB, respectively, were each reviewed by different pathologists. No on-site pathology assistance was available for either FNA or TCB. All cases were performed utilizing a 22-gauge cytology needle for FNA and a 19-gauge Trucut needle (Quickcore) for TCB. The linear array echoendoscope Olympus UCP-140 was used in all cases. McNemar's test and Fisher's exact test were utilized to compare TCB with FNA. Results: A total of 40 patients were included (18M, 22F) with a mean age of 56 years (range 19-82). The lesions were biopsied via the transesophageal (17), transgastric (22), and transduodenal (1) approaches. The final diagnoses were as follows: gastric GIST (15), esophageal leiomyoma (3), pancreatic amyloidosis (1), benign schwannoma (2), sarcoidosis (6) benign granuloma (2), hematoma (1), chronic pancreatitis (2), benign mediastinal lymphadenopathy (6), benign gastric glomus tumor (1) and benign adrenal adenoma (1). The average number of FNA passes was 4.72 (range 2-10) and TCB passes was 2.85 (range 0-6). TCB successfully obtained tissue in 35/40 patients (87.5%), with tissue obtained on the first pass in 24/40 patients (60.0%). Diagnostic accuracy of EUS-FNA was 60.0% (24/40), and for EUS-TCB was 77.5% (31/40) (p = 0.12). When combining FNA + TCB, the diagnostic accuracy increased to 87.5% (35/40) (p = 0.002 vs. FNA alone). Considering only patients in whom TCB provided tissue (35 patients), EUS-TCB had a diagnostic accuracy of 88.5% (31/35) (p = 0.008 vs. FNA alone, Fisher's exact test). One patient with mediastinal biopsy developed fever and chest pain treated with intravenous antibiotic; no surgery was needed. Conclusion: EUS-TCB provides a higher diagnostic accuracy than FNA in patients with benign lesions. When a benign condition is suspected, EUS-TCB should be performed first, and FNA should be used as rescue for cases when EUS-TCB fails to provide a core sample.

Gastric glomus tumor: A hypervascular submucosal tumor on power doppler endosonography

Gastric glomus tumors are rare submucosal lesions that typically occur in the fourth endosonographic layer. We describe a 69-year-old patient who presented with intermittent epigastric pain and in whom a submucosal tumor was encountered during upper gastrointestinal endoscopy. Endosonography revealed a heterogeneous, hypoechoic fourth-layer tumor. Power Doppler imaging revealed prominent intratumoral vascular signals demonstrating its hypervascular nature. A diagnosis of glomus tumor was made via histopathologic evaluation of the resected tumor.

A Clinicopathologic Study of Glomus Tumor of the Stomach

Glomus tumors are benign lesions and originate from modified smooth muscle cells of the glomus body. These tumors are commonly observed in the dermis or subcutis, but only rarely found in the stomach. Here we report a case of a 67-year-old patient in whom glomus tumor of the stomach was diagnosed after 10-day history of melena. We have reviewed the 13 cases selected from literature of gastric glomus tumor in Korean, including our case. The age of onset ranged from 30 to 68 years (median 54 y) with a strong female dominance (10 females and 3 males). The tumors typically presented with gastrointestinal bleeding or ulcerlike symptom, and 6 tumors had mucosal ulceration. The tumor sizes varied from 1.2 to 3.8 cm (median 2.5 cm), and all tumors presented in antrum of stomach. Microscopically, the tumors were well-circumscribed, and composed of uniform, small, round to polygonal cells. Mitotic activity was usually low. The characteristics of gastric glomus tumors in Korean patients are very similar to those of Western populations. Although gastric glomus tumors can be considered more likely benign, a small possibility of malignant behavior cannot be ruled out.

Pathologic quiz case: an incidental gastric massin a 71-year old man who presented with pancreatic pseudocyst. Gastric glomus tumor.

Pathologic quiz case: an incidental gastric massin a 71-year old man who presented with pancreatic pseudocyst. Gastric glomus tumor.

Glomus tumor of the stomach: CT findings

We present the radiologic findings of gastric glomus tumors in two patients, in whom upper gastrointestinal series and computed tomography (CT) were primarily used for diagnosis. The diagnosis was surgically confirmed. Contrast-enhanced CT showed peripheral nodular or homogeneous strong enhancement in the arterial phase and prolonged enhancement in the delayed phase.

胃癌を伴った胃グロームス腫瘍の1例 -本邦報告例の文献的考察-

胃癌を伴った胃グロームス腫瘍の1例 -本邦報告例の文献的考察-

Glomus tumors of the stomach.

Gastric glomus tumors are benign maturely organized proliferations of glomus cells, blood vessels, and occasionally nerve bundles. They are surrounded by hypertrophic smooth muscle forming a pseudocapsule. Because there are no specific clinical or radiologic features associated with the glomus tumor, it can be recognized only by its histologic characteristics. Available data are inadequate for determining the histogenesis of this tumor. It may be a neoplasm, a hamartoma, or a functional hyperplasia. Local resection is sufficient therapy. Diagnosis from a frozen section is often difficult, but the pathologist's awareness of the existence of the gastric glomus tumor can prevent an unnecessarily extensive operative procedure.

Gastric Glomus Tumor

Summary The eighth instance of gastric glomus tumor is reported. Review of the literature discloses an apparent propensity of these tumors to occur in men over 40 and to be associated with upper gastrointestinal bleeding.