Endoscopy-assisted laparoscopic wedge-resection of gastric glomus tumor: A case report

TL;DR

A rare case of gastric glomus tumor was successfully diagnosed and treated using endoscopic and laparoscopic techniques.

Contribution

Demonstrates the effectiveness of endoscopic ultrasound and laparoscopic-endoscopic cooperative surgery for diagnosing and treating gastric glomus tumors.

Findings

Endoscopic ultrasound with fine-needle aspiration enabled accurate preoperative diagnosis of gastric glomus tumor.

Laparoscopic-endoscopic cooperative surgery provided oncologically safe and minimally invasive treatment.

The patient had no recurrence after 8 months of follow-up.

Abstract

Glomus tumor is a pericytic mesenchymal neoplasm that most commonly occurs in the extremities. The occurrence in visceral organs is rare and is a differential diagnosis with other gastric submucosal tumors.

A woman with epigastric pain underwent esophagogastroduodenoscopy (EGD) which revealed a gastric submucosal tumor. Endoscopic ultrasound with fine-needle aspiration allowed preoperative diagnosis of gastric glomus tumor. Intraoperative EGD-assisted laparoscopic segmental gastrectomy was successfully performed. The patient was discharged in the second postoperative day. There was no evidence of recurrence at 8 months of follow-up.

The stomach is a rare location for the glomus tumor, a neoplasm of the glomus body, which is a perivascular structure with thermoregulatory function. Preoperative diagnosis is challenging, and endoscopic ultrasound (EUS) is useful for both assessing malignancy-associated features and biopsy guiding. The treatment is surgical resection with attention to adequate oncological margins while preserving healthy gastric wall.

Immunohistochemical analysis of specimen obtained by EUS fine-needle allows accurate preoperative diagnosis and laparoscopic-endoscopic combined surgery allows good oncological and functional results.

•Gastric glomus tumor is rare submucosal tumor.•Preoperative diagnosis is challenging, and endoscopic ultrasound may be helpful.•Adequate preoperative assessment permits a minimally invasive approach.•Laparoscopic-endoscopic cooperative surgery (LECS) can be oncologically safe.

Gastric glomus tumor is rare submucosal tumor.

Preoperative diagnosis is challenging, and endoscopic ultrasound may be helpful.

Adequate preoperative assessment permits a minimally invasive approach.

Laparoscopic-endoscopic cooperative surgery (LECS) can be oncologically safe.

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