Combined laparoscopic-endoscopic approach for gastric glomus tumor: A case report

Abstract

BACKGROUND Gastric glomus tumor (GGT) is rare submucosal mesenchymal tumor that lacks specific clinical manifestations and is usually treated mainly by traditional surgical resection. This paper presents a case of a GGT, exhibited both intraluminally and extraluminally growth that was removed by laparoscopy-gastroscopy cooperative surgery. CASE SUMMARY A 52-year-old male presented with epigastric discomfort accompanied by a sense of fullness for 3 mo. Upper gastrointestinal endoscopy identified a submucosal lump located in the gastric antrum. Endoscopic ultrasonography identified a 2.4 cm × 1.8 cm lump located in the gastric antrum. It originated from the muscularis propria and exhibited both intraluminally and extraluminally growth, with hypoechoicity on the periphery, hyperechoicity in the middle, and unclear boundaries. Computed tomography showed nodular thickening of 3.0 cm × 2.2 cm in the gastric wall of the gastric antrum, and after enhancement, the lesion exhibited obvious enhancement We suspected that it was a gastrointestinal stromal tumor (glomus tumor and schwannoma were not excluded) and planned to perform laparoscopy-gastroscopy cooperative surgery. Immunohistochemical staining after the operation revealed that spinal muscular atrophy (+), h-caldesmon (+), cluster of differentiation 34 (CD34) (+), 2% Ki-67-positive rate, CD56, melanoma antigen, CD117, discovered on GIST-1, leukocyte common antigen, caudal type homeobox 2, cytokeratin, and S-100 were all negative. The tumor was finally diagnosed as a GGT. CONCLUSION GGTs are rare submucosal tumors of the stomach and should be considered in the differential diagnosis of gastric submucosal tumors. Laparoscopy-gastroscopy cooperative surgery is less invasive and more precise and could be an effective method for the treatment of GGTs.

Gastric glomus tumor resection using laparoscopic endoscopic cooperative surgery: A case report

“…We searched PubMed for GGT resection cases during a 13‐year period from 2008 to 2021. Of the 21 reported cases, six 2,7–10 involved GGTs resected with LECS (Table 1) in three men and women, with a median patient age of 58 years. In these cases, the tumors were mostly located in the antrum of the stomach.…”

A 65-Year-Old Man Presenting to the Emergency Department with Gastric Hemorrhage Caused by a Glomus Tumor

“…In small lesions, it is possible to opt for an excision through endoscopy, but the risks of hemorrhage and perforation must be weighed. Besides these, the endoscopic treatment becomes unnecessary if the margins are positive [ 23 ]. In the case of lymphadenectomy, there is no consensus, as some authors do not consider it routine [ 21 ].…”

Deep Learning-Based Ultrasound Combined with Gastroscope for the Diagnosis and Nursing of Upper Gastrointestinal Submucous Lesions

“…Because the lesion site is often covered by normal mucosa, it is difficult for a routine biopsy to achieve an accurate diagnosis. The development of ultrasound technology has brought benefits to the clinical diagnosis of upper gastrointestinal submucous lesions, especially EUS technology, which combines ultrasound examination with gastroscope examination and can clearly observe the size, boundary, echo characteristics, and origin of digestive tract lesions [ 24 , 25 ]. Akahoshi et al [ 26 ] found that the safety and accuracy of EUS were higher than that of ordinary gastroscope examination.…”