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以胃肠道出血和肺栓塞为表现的胃血管球瘤:一种存在管理困境的罕见实体。

Gastric Glomus Tumor Presenting With Gastrointestinal Bleed and Pulmonary Embolism: A Rare Entity With Management Dilemma.

作者信息

Ezeh Kosisochukwu J, Rajwana Yasir, Paudel Bidhan, Shen Tingliang, Botros Youssef

机构信息

Internal Medicine, Jersey City Medical Center, Jersey City, USA.

Pathology, Rutgers New Jersey Medical School, Newark, USA.

出版信息

Cureus. 2022 Jun 3;14(6):e25632. doi: 10.7759/cureus.25632. eCollection 2022 Jun.

Abstract

Glomus tumors are rare neoplasms originating from smooth muscle cells of the glomus body. They rarely involve the gastrointestinal tract, and when they do, they present as acute gastrointestinal bleeds with symptoms such as hematemesis or melena. We present a rare case of a gastric glomus tumor in a 50- year- old male presenting with shortness of breath and gastrointestinal bleed requiring transfusions. Coincidently, he was also found to have a pulmonary embolism that usually would require anticoagulation, which was contraindicated in an active gastrointestinal bleed. He eventually required an inferior vena cava (IVC) filter and underwent a partial gastrectomy. Due to gastric glomus tumor being a rare entity, there is a paucity of data to have a classification and grading or staging system, and tumors are usually considered benign. The exact diagnosis is dependent on histopathological findings as it can mimic a gastrointestinal stromal tumor (GIST). Pulmonary embolism, a common phenomenon, can often be seen in patients with malignancy. Our patient was diagnosed with a glomus tumor which is usually benign. As per our literature search, there are no documented cases of GGT with concomitant Pulmonary embolism diagnosis that would point to a causal association.

摘要

血管球瘤是起源于血管球平滑肌细胞的罕见肿瘤。它们很少累及胃肠道,一旦累及,会表现为急性胃肠道出血,伴有呕血或黑便等症状。我们报告了一例罕见的胃血管球瘤病例,患者为一名50岁男性,表现为呼吸急促和需要输血的胃肠道出血。巧合的是,他还被发现患有肺栓塞,通常这种情况需要抗凝治疗,但在活动性胃肠道出血时这是禁忌的。他最终需要植入下腔静脉(IVC)滤器并接受了部分胃切除术。由于胃血管球瘤是一种罕见的疾病,缺乏用于分类、分级或分期系统的数据,且肿瘤通常被认为是良性的。确切诊断取决于组织病理学结果,因为它可能会模仿胃肠道间质瘤(GIST)。肺栓塞是一种常见现象,在恶性肿瘤患者中经常可见。我们的患者被诊断为通常为良性的血管球瘤。根据我们的文献检索,没有记录在案的同时诊断为胃血管球瘤和肺栓塞的病例表明存在因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9079/9250802/f33cb8f886f5/cureus-0014-00000025632-i01.jpg

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