J Korean Surg Soc.  2009 Dec;77(Suppl):S9-S12. 10.4174/jkss.2009.77.Suppl.S9.

Gastric Glomus Tumor

• Kim DH
• Kim DH
• Jeon TY
• Kim HS
• Kim JH
• Kim TO
• Kim GH
• Song GA
• Kim S
• Park DY

• KMID: 1464790
• DOI: http://doi.org/10.4174/jkss.2009.77.Suppl.S9

Abstract

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.

Keyword

Glomus tumor; Stomach; Laparoscopic wedge resection

MeSH Terms

Endoscopy
Endosonography
Gastrointestinal Stromal Tumors
Glomus Tumor
Humans
Immunohistochemistry
Leiomyoma
Myocytes, Smooth Muscle
Neurilemmoma
Stomach

Figure

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  Fig. 1 Endoscopic finding. Mucosal bulge suggestive of submucosal tumor located in anterior wall of gastric antrum.

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  Fig. 2 Endoscopic ultrasonography finding. A 2.7×1.6 cm sized well circumscribed heterogenous hypoechoic mass in the fourth sonographic layer of the gastric wall.

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  Fig. 3 Portal-venous-phase contrast-enhanced CT finding. An enhancing mass. Density of mass is mostly consistent with that of portal vein but higher than spleen.

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  Fig. 4 Operative finding. An endoscopic stapler is placed across gastric wall containg tumor.

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  Fig. 5 Histologic finding. (A) Shows typical small uniform, round cells with centrally located punched out nuclei, pale cytoplasm and well defined cell membrane and show no mitosis or nuclear aypia (H&E stain, ×400). (B) On immunohistochemistry, tumor cells are positive for smooth muscle actin (Immunohistochemical stain, ×200).

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