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Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report

INTRODUCTION: Glomus tumors are rare neoplasms that aris­e from neuromyoarterial canal or glomus body. They are mainly found in the peripheral soft tissue, extremities and rarely developed inside the gastrointestinal tract. In the gastrointestinal tract, the stomach is the most common site for the d...

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Autores principales: Alsahwan, Abdullah G., Alfaraj, Zainab M., AlSafwani, Jihad, Bunaiyan, Abdullah H., AlKhalifah, Ridha H., Al-Saba'a, Sumayah A., Al-Momen, Sami A., Aldolah, Qassim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045044/
https://www.ncbi.nlm.nih.gov/pubmed/33887847
http://dx.doi.org/10.1016/j.ijscr.2021.105802
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author Alsahwan, Abdullah G.
Alfaraj, Zainab M.
AlSafwani, Jihad
Bunaiyan, Abdullah H.
AlKhalifah, Ridha H.
Al-Saba'a, Sumayah A.
Al-Momen, Sami A.
Aldolah, Qassim
author_facet Alsahwan, Abdullah G.
Alfaraj, Zainab M.
AlSafwani, Jihad
Bunaiyan, Abdullah H.
AlKhalifah, Ridha H.
Al-Saba'a, Sumayah A.
Al-Momen, Sami A.
Aldolah, Qassim
author_sort Alsahwan, Abdullah G.
collection PubMed
description INTRODUCTION: Glomus tumors are rare neoplasms that aris­e from neuromyoarterial canal or glomus body. They are mainly found in the peripheral soft tissue, extremities and rarely developed inside the gastrointestinal tract. In the gastrointestinal tract, the stomach is the most common site for the development of glomus tumors, and most often found in the antrum. Usually, the symptoms of gastric glomus tumors are non specific i.e (abdominal pain, GI bleeding and/or perforation) and possibly discovered incidentally during upper GI endoscopy. CASE PRESENTATION: This is a-56-year-old-male, presented to the emergency department with upper GI bleeding i.e (melena), and signs of shock (HR: 110; BP:80/60), Blood tests showed Hemoglobin level: 5 g/dl. Resuscitation was started with IV fluid and transfusion of 4 units of PRBCs. After resuscitation, He gave a 10 days history of passing black tarry stool, palpitation, headache, dizziness, easily fatigability, malaise, and colicky epigastric abdominal pain. His abdomen was soft, lax with no tenderness, there was fullness at the left upper quadrant. Upper GI endoscopy was performed that showed a large gastric ulcer with adherent clots, necrotic base and oozing at the proximal part of the greater curvature, after that the bleeding was managed with a heater probe and epinephrine injections. The histopathological examination of the biopsy revealed a spindle and epithelioid tumor with the top differential diagnosis being GIST, however other submucosal lesions cannot be excluded. After that, He underwent exploratory laparotomy and wedge resection of the tumor. The final histopathology showed a malignant glomus tumor. CLINICAL DISCUSSION: Due to overlapping clinical and radiological features between glomus, GIST and other submucosal lesions, the histopathological examination is considered to be the gold standard for the diagnosis. Surgical resection with negative margin is the treatment of choice for gastric glomus tumors. CONCLUSION: Although gastric glomus tumor is a rare entity and accounts for 1% of all gastric mesenchymal tumors, it should be considered in the differential diagnosis, since preoperative biopsy is difficult and overlapping features with other submucosal lesions. Surgical treatment is the preferred option for gastric glomus tumor and long-term follow-up is required due to high metastatic and recurrence rate in the malignant type.
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spelling pubmed-80450442021-04-16 Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report Alsahwan, Abdullah G. Alfaraj, Zainab M. AlSafwani, Jihad Bunaiyan, Abdullah H. AlKhalifah, Ridha H. Al-Saba'a, Sumayah A. Al-Momen, Sami A. Aldolah, Qassim Int J Surg Case Rep Case Report INTRODUCTION: Glomus tumors are rare neoplasms that aris­e from neuromyoarterial canal or glomus body. They are mainly found in the peripheral soft tissue, extremities and rarely developed inside the gastrointestinal tract. In the gastrointestinal tract, the stomach is the most common site for the development of glomus tumors, and most often found in the antrum. Usually, the symptoms of gastric glomus tumors are non specific i.e (abdominal pain, GI bleeding and/or perforation) and possibly discovered incidentally during upper GI endoscopy. CASE PRESENTATION: This is a-56-year-old-male, presented to the emergency department with upper GI bleeding i.e (melena), and signs of shock (HR: 110; BP:80/60), Blood tests showed Hemoglobin level: 5 g/dl. Resuscitation was started with IV fluid and transfusion of 4 units of PRBCs. After resuscitation, He gave a 10 days history of passing black tarry stool, palpitation, headache, dizziness, easily fatigability, malaise, and colicky epigastric abdominal pain. His abdomen was soft, lax with no tenderness, there was fullness at the left upper quadrant. Upper GI endoscopy was performed that showed a large gastric ulcer with adherent clots, necrotic base and oozing at the proximal part of the greater curvature, after that the bleeding was managed with a heater probe and epinephrine injections. The histopathological examination of the biopsy revealed a spindle and epithelioid tumor with the top differential diagnosis being GIST, however other submucosal lesions cannot be excluded. After that, He underwent exploratory laparotomy and wedge resection of the tumor. The final histopathology showed a malignant glomus tumor. CLINICAL DISCUSSION: Due to overlapping clinical and radiological features between glomus, GIST and other submucosal lesions, the histopathological examination is considered to be the gold standard for the diagnosis. Surgical resection with negative margin is the treatment of choice for gastric glomus tumors. CONCLUSION: Although gastric glomus tumor is a rare entity and accounts for 1% of all gastric mesenchymal tumors, it should be considered in the differential diagnosis, since preoperative biopsy is difficult and overlapping features with other submucosal lesions. Surgical treatment is the preferred option for gastric glomus tumor and long-term follow-up is required due to high metastatic and recurrence rate in the malignant type. Elsevier 2021-03-23 /pmc/articles/PMC8045044/ /pubmed/33887847 http://dx.doi.org/10.1016/j.ijscr.2021.105802 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Alsahwan, Abdullah G.
Alfaraj, Zainab M.
AlSafwani, Jihad
Bunaiyan, Abdullah H.
AlKhalifah, Ridha H.
Al-Saba'a, Sumayah A.
Al-Momen, Sami A.
Aldolah, Qassim
Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report
title Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report
title_full Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report
title_fullStr Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report
title_full_unstemmed Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report
title_short Rare gastric neoplasm: Malignant glomus tumor of the stomach. A case report
title_sort rare gastric neoplasm: malignant glomus tumor of the stomach. a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045044/
https://www.ncbi.nlm.nih.gov/pubmed/33887847
http://dx.doi.org/10.1016/j.ijscr.2021.105802
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