Endoscopic ultrasonography diagnosis of gastric glomus tumors

Abstract

BACKGROUND A gastric glomus tumor is relatively rare, and there is little knowledge on its endoscopic ultrasound findings. AIM To assess the accuracy of endoscopic ultrasonography (EUS) in the diagnosis of gastric glomus tumor and to discuss its value by reviewing the literature. METHODS A retrospective analysis of the EUS characteristics of gastric glomus tumor (such as tumor location, shape, size, echogenicity, homogeneity, margins, layer of origin, and so on) was performed. The study included 12 cases of gastric glomus tumor confirmed by surgery and pathology (7 females and 5 males, age range 36-74 years, average age was 58.2 years). RESULTS All the lesions were located in the gastric antrum (12 cases), protruding into the cavity, with a diameter between 1 and 3.5 cm. Glomus tumor of the stomach manifested as a circumscribed and slightly hypoechoic mass in the fourth layer, with an internal heterogeneous echo mixed with hyperechogenic spots and a marginal more hypoechoic halo. Smooth muscle actin, h-caldesmon and vimentin were shown to be positive by immunohistochemistry. CONCLUSION Although glomus tumor of the stomach is relatively rare, a typical glomus tumor of the stomach has characteristic changes under EUS.

Tumor Glômico Gástrico: Um caso raro de neoplasia benigna

“…Estes tumores surgem em estruturas perivasculares, denominadas corpo glômico, localizadas nas extremidades. Tais estruturas estão envolvidas principalmente na regulação da temperatura central e na homeostase, consistindo num shunt arteriovenoso (o canal Sucquet-Hoyer) (Bai, et al, 2021;Chabowski, et al, 2016;Gupta, et al, 2020;Tantia, et al, 2021;Vig, et al, 2017). Esta lesão no sistema gástrico foi primeiramente descrita em 1951 por Kay e colaboradores, e hoje representa aproximadamente 1 % de todas as neoplasias mesenquimais gástricas que surgem na submucosa e na muscular própria (Alsahwan, et al, 2021;Aoba, et al, 2018;Hasuda, et al, 2021;Xing, et al, 2022).…”

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

“…Asymptomatic cases can be detected accidentally during a gastrointestinal endoscopy [ 14 ]. The most common diagnostic methods consist of endoscopic ultrasonography and CT. Endoscopic ultrasonography reveals well-defined masses with frequent localization in the third or fourth gastric layers (submucosa and muscularis propria, respectively), with predominantly hypoechoic appearance with hyperechoic areas, due to its vascular nature [ 15 – 17 ]. Aspects that can suggest malignancy are represented by irregular edges, cystic or necrotic areas, and echogenic areas [ 15 ].…”

Unsuspected gastric glomus tumour

“…In the GI tract, the lesser curvature of the gastric antrum is the most common site for GT 6–9. Gastric glomus tumours (GGTs) typically arise from the gastric submucosa or muscularis and project either into the lumen or serosa 3–5 7.…”

“…These modalities are rarely sufficient to make a preoperative diagnosis of GGTs. In addition, accurate diagnosis of GGTs is limited by the overlapping features shared with other gastric submucosal tumours 9 12 13. Therefore, almost all GGTs are diagnosed postoperatively from resected pathology specimens using immunohistochemistry 7 11 14.…”