Gastric Glomus Tumor: A Case Report and Review of the Literature

Abstract

Glomus tumors are usually thought of as benign tumors although some malignant cases have been reported. These tumors arise from the glomus body and are commonly observed in the dermis or subcutis, but rarely in visceral organs. Here, we report a 37-year-old female who initially presented with epigastric discomfort. The preoperative diagnosis was a gastrointestinal stromal tumor. A minilaparotomy was done with an incision length of 4 cm followed by wedge resection. The final pathologic diagnosis was a gastric glomus tumor. We have reviewed the only five cases of gastric glomus tumors that have been reported to date in Taiwan, including the present case, and compare these cases with those reported in other countries. The age of onset ranged from 35 to 69 years (median, 41 years) with female dominance (4 females and 1 male). Two of the five cases presented with gastrointestinal bleeding with an ulcerative tumor, and the others only had epigastric discomfort. The tumors were located around the prepyloric antrum of the stomach. No definite diagnosis was reached before surgery in any of the five cases, and all of the tumors were considered likely to be benign lesions. Clinicians who treat such patients should be aware of this problem because of the difficulty in accurate preoperative diagnosis.

Glomus Tumor of the Stomach: A Rare Cause of Upper Gastrointestinal Bleeding

“…The glomus apparatus consists of three vascular components: an afferent artery separated from an efferent venule by convoluted channels [10]. They are commonly observed wherever arteriovenous anastomoses functioning without an intermediary capillary bed are present, are sensitive to temperature variation, and play a role in regulating arterial blood flow [4, 8]. Glomus tumors are commonly observed in the extremities and are rarely found in visceral organs , but they have also been described in the bone and joints, skeletal muscle, soft tissue, thimpanus, mediastinum, trachea, kidney, uterus, and vagina [11].…”

“…The first case of GT located in stomach is credited to Talijeva in 1928 [5, 14], and since then few cases have been published [4]. The incidence of gastric GT is much less common than gastrointestinal stromal tumors (GISTs) with only 1 in 100 diagnosis of GISTs being gastric GT [7].…”

“…GT usually is a benign neoplasm, and the malignant variant is extremely rare with a few case reports in the literature [3, 4]. Smol'jyannikov wrote that the first GT of the stomach was described by Talijeva in 1928 and, since then, less than 200 cases have been published in the worlds' literature [3, 5, 6].…”

Glomus tumor in the stomach: A case report and review of the literature

“…Malignant glomus tumors of the stomach with various organ metastases have been reported (6,7). Criteria for identifying malignant potential in gastric glomus tumors remain to be established (8). …”

“…Fine needle aspiration (FNA) can distinguish glomus tumors from more aggressive gastric tumors rapidly and pre-operatively, avoiding extensive surgical resection, particularly in larger tumors (8,15,16). However, FNA can also incorrectly diagnose glomus tumors as leiomyomas or well-differentiated neuroendocrine tumors (2).…”