Glomus tumor of the stomach simulating a gastrointestinal stromal tumor: a case report and review of literature

Abstract

Glomus tumor is an infrequent and in most cases benign mesenchymal neoplasia which affects subcutaneous/submucosal tissue and occurs in the gastrointestinal tract, solid organs (e.g. liver, kidney) and the extremities. Visceral glomus tumor of the stomach generally presents with non-specific epigastric pain, loss of appetite and GI bleeding (melaena), often without haemodynamic instability. Macroscopic appearances on upper GI endoscopy are non-diagnostic. Endosonographic appearances are generally heterogenous and poorly-reflective, hence fail to differentiate glomus tumor from other potential diagnoses. Histological confirmation of the diagnosis is only possible when a fine needle biopsy is inclusive of abnormal tissue. These difficulties in diagnosis mean that in many cases, only immunohistochemical analysis of surgically resected tissue can distinguish glomus tumor from several possible differentials. Therefore, endoscopically-assisted laparoscopic curative wedge-resection of a lesion suspicious for glomus tumor of the upper gastrointestinal tract must be considered first-line in terms of a combined investigative and curative approach.

Keywords: GIST; Gastric glomangioblastoma; Glomus tumor.

Fig. 1

a Endoscopy of the glomus tumor, showing a spherical, submucosal solid tumor, located in the pyloric antrum with b endosonographically poorly reflective, inhomogeneous pattern and echo-free areas.

Fig. 2

Immunohistochemistry; a negative CD 117-Ab reaction; b positive reaction on vimentin/actin staining (magnification 200×).