Clinical Report: Gastric Glomus Tumor Diagnosis and Management
Overview
A 70-year-old female was diagnosed with a gastric glomus tumor (GT) incidentally found during surgery. Diagnosis was confirmed by EUS-FNA cytology and immunohistochemistry, and the lesion was successfully treated with laparoscopic wedge resection.
Background
Glomus tumors are rare vascular neoplasms typically found in extremities but can occur in visceral organs such as the stomach. Gastric GTs usually present as submucosal masses in the antrum and may cause symptoms ranging from gastrointestinal bleeding to epigastric discomfort. Imaging modalities like endoscopic ultrasound (EUS) and computed tomography (CT) aid in evaluation, but definitive diagnosis relies on pathological and immunohistochemical analysis. These tumors are generally benign with favorable prognosis following surgical excision.
Data Highlights
Parameter
Finding
Patient Age
70 years
Lesion Size (macroscopic)
2.5 × 1.6 × 1.2 cm
Lesion Size (CT scan)
14 mm
Location
Gastric antrum near pylorus, greater curvature
Immunohistochemistry
Positive for smooth muscle actin; negative for desmin, chromogranin, synaptophysin, keratin
Surgical Approach
Laparoscopic wedge resection
Postoperative Outcome
Discharged on postoperative day 4; margins free of disease
Key Findings
Gastric glomus tumors are rare and often misdiagnosed as gastrointestinal stromal tumors (GIST) or gastric cancer due to similar endoscopic appearance.
EUS-FNA with on-site cytopathology provides a rapid and accurate diagnosis with a 95.6% accuracy rate for gastric submucosal tumors.
Immunohistochemical staining is essential for diagnosis, showing positivity for smooth muscle actin and negativity for markers such as desmin, cytokeratin, and CD117.
CT imaging reveals a hyperdense lesion with arterial phase enhancement, aiding localization and surgical planning.
Laparoscopic wedge resection is an effective minimally invasive treatment for small benign gastric GTs, allowing early discharge and good postoperative recovery.
Complete surgical excision with negative margins offers a favorable prognosis given the benign nature of gastric glomus tumors.
Clinical Implications
Clinicians should consider gastric glomus tumor in the differential diagnosis of submucosal gastric masses, especially when imaging and endoscopy suggest GIST. EUS-FNA combined with immunohistochemistry is critical for accurate diagnosis, guiding appropriate surgical management. Minimally invasive laparoscopic wedge resection is recommended for small, benign lesions to achieve curative resection with minimal morbidity.
Conclusion
Gastric glomus tumors, though rare, can be effectively diagnosed using EUS-FNA and immunohistochemistry and treated successfully with laparoscopic wedge resection. This approach ensures accurate diagnosis and favorable patient outcomes with minimal invasiveness.
References
Case Study Authors 2024 -- Gastric Glomus Tumor: A Case Study with Imaging Findings
