Glomus Tumor of the Stomach: GI Image

Excerpt

A 70-year-old female presented to our attention with an incidental finding, of a gastric mass, during videolaparoscopic cholecystectomy; the surgeon described a mass forming lesion within the gastric wall that did not erose the serosa. The patient underwent different gastroscopies, and during the last gastroscopic control, the endoscopist found a significant increasement of the well-known mass (2 cm in diameter), located in the gastric antrum nearby the pylorum laying in the greater curvature. According to the macroscopic findings, our first diagnostic hypothesis was of GIST. Then, an EUS-FNA (Fig. 1) was performed with on-site cytopathology assistance to evaluate the adequacy of material. The cytopathology smear showed a population of uniform, round epithelioid cells, with relatively small nucleoli and variable eosinophilic cytoplasm, which stained for smooth muscle actin but were negative for desmin, chromogranin, synapthophisin, and keratin (Fig. 2). A final cytological diagnosis of glomus tumor (GT) of the stomach was obtained. The patient underwent a CT scan (Fig. 3) that confirmed the presence of a hyperdense lesion of about 14 mm, in the absence of lymphadenomegaly or metastatic disease. There weren’t any contraindications for surgery, so we decided to perform a gastric laparoscopic wedge resection of the lesion (Fig. 4). Laparoscopy is a good minimally invasive technique in case of small and benign tumors, which allowed us to discharge the patient in the fourth postoperative day. Macroscopically, the lesion measured 2.5 × 1.6 × 1.2 cm with well-defined borders and rubbery consistency. The histological examination confirmed the cytological diagnosis of GT of the stomach with surgical margins free of disease.

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