Gastric glomus tumor with a rare presentation: a case report and review of the literature.

INTRODUCTION AND IMPORTANCE

Gastric glomus tumors (GGT) are rare soft tissue tumors of the gastrointestinal tracts (GIT). It is somewhat challenging to establish the diagnosis of GGT and differentiate it from the more common submucosal neoplasms.

CASE PRESENTATION

A 34-year-old female patient presented with upper gastrointestinal bleeding. Extensive workup including endoscopic ultrasonography (EUS) revealed a well-circumscribed isoechoic mass arising from the muscularis propria. Based on fine needle biopsy (FNB) findings, with H&E stains performed only initially, the mass was considered a neuroendocrine tumor (NET). Antrectomy with Billroth II anastomosis was performed. A microscopic and immunohistochemical studies of the resected specimen showed the cells to be positive for smooth muscle actin (SMA) making GGT the final diagnosis.

CLINICAL DISCUSSION

Of the 116 patients included in our analysis, 56.9% (=66) were females and age group was between 41 and 64 years old in 63.8% (=74) of the patients. About 55 cases (47.4%) had abdominal or epigastric pain or discomfort, which was the most frequent clinical symptom. In immunohistochemistry, SMA staining is present in 68.1% of the cases, underscoring its diagnostic significance. Laparotomy with wedge or partial gastrectomy was employed in 46.1% of the recorded cases. Due to malignant potential, long-term follow-up and monitoring are usually recommended.

CONCLUSION

Despite the rarity of GGT, they should be included in the differential diagnosis of gastric submucosal tumors, with immunohistochemistry studies playing a major role in the diagnosis. Furthermore, a comprehensive evaluation of the literature in the past 8 years was presented in a table.