Gastric glomus tumor: Analysis of endosonographic characteristics and computed tomographic findings

Abstract

Among submucosal tumors (SMT), gastric glomus tumors are rare vascular tumors, and only a few cases where glomus tumors have been differentiated from other mesenchymal tumors by endoscopic ultrasonography (EUS) or computed tomography (CT) have been reported. In this case series, we aimed to analyze the EUS and CT characteristics of gastric glomus tumors. Seven patients with gastric glomus tumors were retrospectively enrolled in this study. EUS showed that all the tumors were located in the fourth EUS layer (muscularis propria) and had distinct borders. The tumors had a heterogeneous appearance with either hypo- or hyperechogenicity, and all the tumors except one had the characteristic peripheral halo around them. On CT scans,all the tumors appeared as well-defined SMT with a clear margin and showed the same characteristics in the different phases of CT. During dynamic contrast-enhanced CT, the tumors showed strong enhancement in the arterial phase and prolonged enhancement in the delayed phase. This case series shows the characteristic EUS findings and the distinguishing features of CT scans for gastric glomus tumors; these findings will help in differentiating gastric glomus tumors from other SMT.

Glomus tumor in the stomach: A case report and review of the literature

“…Following the administration of contrast medium, these tumors demonstrate strong enhancement on arterial-phase scans and persistent enhancement on portal venous-phase scans (2). By contrast, the density of gastrointestinal stromal tumors is lower and these do not exhibit prolonged enhancement in the delayed phase (9). EUS features of gastric glomus tumors are heterogeneous, hypoechoic or hyperechoic, and hypervascular masses with internal hyperechoic spots and few tubular structures, mostly located on the fourth echolayer (10,11).…”

“…To minimize surgical trauma and the inflammatory response, the benign nature and small median size [varying between 2 and 3 cm (19)] of glomus tumors allows them to be removed by laparoscopic wedge resection (9,20–22), or endoscopic submucosal enucleation in select cases (22,23) where the lesion is not close to the pylorus, porta hepatis and along the lesser curvature (24). …”

Gastrointestinal tract spindle cell lesions—just like real estate, it's all about location

“…Imaging studies may be diagnostically helpful; on endoscopic ultrasound, the tumor has distinct borders and shows a characteristic peripheral halo sign. 3 On dynamic contrast-enhanced computer tomography, these tumors may show hemangioma-like globular enhancement. In one study, this pattern was exclusively observed in gastric or duodenal glomus tumors and was absent in other subepithelial lesions such as gastrointestinal stromal tumor (GIST), schwannoma, ectopic pancreas, and leiomyoma.…”

Combined EUS and CT for evaluating gastrointestinal submucosal tumors before endoscopic resection

“…Is endoscopic ultrasonography (EUS) an independent competent in such a task [11][12][13][14][15][16][17][18][19]? Moreover, some SMTs can only be surgically excised.…”