Matevossian Edouard, Brücher Björn L D M, Nährig Jörg, Feußner Hubertus, Hüser Norbert
Department of Surgery, Technical University of Munich, Munich, Germany.
Case Rep Gastroenterol. 2008 Jan 10;2(1):1-5. doi: 10.1159/000112862.
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.
血管球瘤是一种罕见的、在大多数情况下为良性的间叶性肿瘤，可累及皮下/黏膜下组织，发生于胃肠道、实体器官（如肝脏、肾脏）及四肢。胃的内脏血管球瘤通常表现为非特异性上腹部疼痛、食欲不振和胃肠道出血（黑便），通常无血流动力学不稳定。上消化道内镜检查的宏观表现无诊断价值。内镜超声表现通常不均匀且反射性差，因此无法将血管球瘤与其他可能的诊断区分开来。只有当细针穿刺活检包含异常组织时，才能进行组织学确诊。这些诊断困难意味着在许多情况下，只有对手术切除组织进行免疫组化分析，才能将血管球瘤与几种可能的鉴别诊断区分开来。因此，就联合检查和治疗方法而言，对于上消化道疑似血管球瘤病变的内镜辅助腹腔镜根治性楔形切除术必须被视为一线治疗方法。
