Nascimento Enzo Fabrício Ribeiro, Fonte Fábio Piovezan, Mendonça Roberta Laís, Nonose Ronaldo, de Souza Carlos Alberto Fonte, Martinez Carlos Augusto Real
Department of General Surgery, São Francisco University Hospital, 09190-370 Bragança Paulista, SP, Brazil.
Case Rep Surg. 2011;2011:371082. doi: 10.1155/2011/371082. Epub 2011 Oct 29.
Introduction. Glomus tumors (GTs) are benign neoplasm originating from the glomus body, commonly described in subungual region. The involvement abdominal is rare. Our aim is to describe a case of glomus tumor of the stomach that presented upper gastrointestinal bleeding. A 34-year-old woman was admitted with upper gastrointestinal bleeding and underwent an upper endoscopy that showed bleeding arising from an ulcerated lesion, treated by sclerosis therapy. A new endoscopy confirmed a submucosal lesion in upper portion of the stomach. During the laparotomy, a tumor at the upper anterior wall of gastric body was found and resected by a vertical gastrectomy. The pathological exam revealed hyperplastic smooth muscle fibers of the muscularis propria of the stomach wall, surrounded by hyaline stroma. The immunohistochemistry panel was positive for smooth muscle actin and type IV collagen, with low rate of mitosis studied by Ki-67 which allowed the final diagnosis of a gastric glomus tumor. Discussion. The majority of intraperitoneal glomus tumors occur in the stomach, and it is phenotypically similar to those localized in peripheral sites. Gastric GT generally is a benign tumor although it can be malignant and have the potential to metastasize. Conclusion. Even though gastric glomus tumor is rarely described, it should be considered as a possible cause of a major upper gastrointestinal bleeding.
引言。血管球瘤（GTs）是起源于血管球的良性肿瘤，常见于甲下区域。腹部受累罕见。我们的目的是描述一例表现为上消化道出血的胃血管球瘤病例。一名34岁女性因上消化道出血入院，接受了上消化道内镜检查，发现出血源自一个溃疡病变，采用硬化疗法进行了治疗。再次内镜检查证实胃上部有一个黏膜下病变。剖腹手术时，在胃体前壁上部发现一个肿瘤，通过垂直胃切除术将其切除。病理检查显示胃壁固有肌层的平滑肌纤维增生，周围有透明质基质。免疫组织化学检测平滑肌肌动蛋白和IV型胶原呈阳性，通过Ki-67检测有丝分裂率较低，最终诊断为胃血管球瘤。讨论。大多数腹腔内血管球瘤发生在胃，其表型与外周部位的相似。胃血管球瘤通常是良性肿瘤，尽管也可能是恶性的并有转移的可能。结论。尽管胃血管球瘤很少被描述，但应将其视为上消化道大出血的一个可能原因。
