Glomus tumor of the stomach: a clinicopathologic analysis of 10 cases and review of the literature

Abstract

Background/aims: Gastric glomus tumors are extremely rare, and presurgical confirmation is often impossible. The identification of clinical and radiologic characteristics of this tumor type is important for preoperative diagnosis and treatment planning.

Methods: In this study, we analyzed 10 cases of gastric glomus tumors resected at a single institute over 9 years.

Results: Eight of the patients were men and 2 were women, with a mean age of 49 years. Five patients presented with abdominal discomfort or pain, 1 presented with anemia, and the remaining 4 cases were found incidentally during endoscopic examinations. The most common location of the tumor was the antrum (n=7), followed by the low (n=2) and high body (n=1). Although the endoscopic ultrasonography findings were variable, contrast-enhanced computed tomography generally showed a strong homogeneous enhancement. The resected tumors were well-demarcated solid masses with sizes ranging from 1.0 to 3.6 cm. Microscopically, the masses were composed of abundant vascular channels with clusters of uniform and round glomus cells. There was no evidence of recurrence after complete surgical resection.

Conclusions: Gastric glomus tumors are unusual, distinct lesions that should be considered in the differential diagnosis of a gastric submucosal mass. Unlike their deep soft tissue counterparts, most glomus tumors in the stomach are benign.

Keywords: Endoscopy; Glomus tumor; Pathology; Radiology; Stomach.

Fig. 1

(A) Gastrointestinal endoscopy showing a round elevated lesion with an overlying normal mucosa. (B) In case number 9, a mucosal ulceration is observed.

Fig. 2

(A) Endoscopic ultrasonography in case number 4 shows a hypoechoic mass. (B) Case number 9 shows heterogeneous echogenicity due to internal hemorrhage and calcification. (C) A computed tomography (CT) scan demonstrates a homogeneously enhanced ovoid mass in the anterior wall of the stomach. Perigastric fat infiltration or lymph node enlargement was not noted. (D) The CT scan of case number 9 reveals a heterogeneously enhanced mass in the posterior wall, which may have been caused by hemorrhage or necrosis.

Fig. 3

Case number 9 has an infiltrative margin (A, H&E stain, ×4) and reveals hemorrhagic necrosis (B, H&E stain, ×10; C, H&E stain, ×20) with foci of calcification (D, H&E stain, ×20).

Fig. 4

Representative photomicrograph of a soild growth pattern (A, H&E stain, ×10) and an angiomatous pattern (B, H&E stain, ×10). The tumors are positive for smooth muscle actin (C, ×20) and vimentin (D, ×20).