Cargando…
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...
Autores principales: | , , , , , , , |
---|---|
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 |
_version_ | 1783678622106648576 |
---|---|
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. |
format | Online Article Text |
id | pubmed-8045044 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT alsahwanabdullahg raregastricneoplasmmalignantglomustumorofthestomachacasereport AT alfarajzainabm raregastricneoplasmmalignantglomustumorofthestomachacasereport AT alsafwanijihad raregastricneoplasmmalignantglomustumorofthestomachacasereport AT bunaiyanabdullahh raregastricneoplasmmalignantglomustumorofthestomachacasereport AT alkhalifahridhah raregastricneoplasmmalignantglomustumorofthestomachacasereport AT alsabaasumayaha raregastricneoplasmmalignantglomustumorofthestomachacasereport AT almomensamia raregastricneoplasmmalignantglomustumorofthestomachacasereport AT aldolahqassim raregastricneoplasmmalignantglomustumorofthestomachacasereport |