Xu Shining, Xu Teng, Zhi Yihao, Dong Feng, Wu Chao, Zheng Minhua
Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Minimally Invasive Surgery Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Med Case Rep. 2025 May 1;19(1):199. doi: 10.1186/s13256-025-05211-4.
Glomus tumors are mesenchymal tumors originating from the neuromuscular arterial canal or vascular lumen. While most gastric glomus tumors are benign and solitary, rare cases can be malignant and have a poor prognosis. Definitive treatment options remain limited for multifocal metastases, often necessitating salvage therapy.
A 36-year-old Han Chinese female patient presented with hematemesis, melena, and syncope persisting for four days. Diagnostic evaluations revealed a malignant gastric glomus tumor, prompting radical resection. During follow-up, radiological imaging identified liver metastases. Subsequent management included radiofrequency ablation and laparoscopic resection of select lesions.
Gastric glomus tumors pose diagnostic challenges owing to radiological and pathological features that overlap with gastrointestinal stromal tumors. Immunohistochemistry remains critical for definitive diagnosis. While Folpe's criteria for malignant gastric glomus tumors have limitations, they provide a practical framework. Our findings suggest that surgical resection followed by radiofrequency ablation may offer effective local control for recurrent or metastatic gastric glomus tumors. Further research is warranted to explore targeted therapies based on molecular profiling.
血管球瘤是起源于神经肌肉动脉管或血管腔的间叶组织肿瘤。虽然大多数胃血管球瘤是良性且孤立的，但罕见情况下可能是恶性的，预后较差。对于多灶性转移，明确的治疗选择仍然有限，通常需要挽救性治疗。
一名36岁的汉族女性患者出现持续四天的呕血、黑便和晕厥。诊断评估发现为恶性胃血管球瘤，遂进行根治性切除。随访期间，影像学检查发现肝转移。后续治疗包括射频消融和对部分病灶进行腹腔镜切除。
胃血管球瘤因其影像学和病理学特征与胃肠道间质瘤重叠而带来诊断挑战。免疫组织化学对于明确诊断仍然至关重要。虽然福尔普（Folpe）关于恶性胃血管球瘤的标准存在局限性，但它们提供了一个实用的框架。我们的研究结果表明，手术切除后进行射频消融可能为复发性或转移性胃血管球瘤提供有效的局部控制。有必要进一步研究以探索基于分子谱的靶向治疗。
