Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2021; 9(24): 7181-7188
Published online Aug 26, 2021. doi: 10.12998/wjcc.v9.i24.7181
Combined laparoscopic-endoscopic approach for gastric glomus tumor: A case report
Wen-Hao Wang, Ting-Ting Shen, Zhi-Xing Gao, Xin Zhang, Zhao-Hui Zhai, Yu-Li Li
Wen-Hao Wang, Ting-Ting Shen, Clinical Medical College, Weifang Medical University, Weifang 261042, Shandong Province, China
Zhi-Xing Gao, Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang 261042, Shandong Province, China
Xin Zhang, The Plastic Surgery Hospital of Weifang University, Weifang Medical University, Weifang 261042, Shandong Province, China
Zhao-Hui Zhai, Yu-Li Li, Plastic Surgery Institute of Weifang Medical University, Yuhe Campus of Weifang Medical University, Weifang 261042, Shandong Province, China
Author contributions: Wang WH, Shen TT, and Zhang X were the graduate students, reviewed the literature, and contributed to manuscript; Wang WH and Gao ZX performed the surgical method analyses and interpretation, and contributed to manuscript drafting; Zhai ZH analyzed and interpreted the imaging findings; Li YL was responsible for the revision of the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Supported by Key Program of Shandong Provincial Natural Science Foundation, No. ZR2020KE018; The Project of Shandong Province Higher Educational Science and Technology Program, No. J17KA253; The Medical Science and Technology Development Project of Shandong, No. 2018WS062; and Weifang Science and Technology Development Plan, No. 2020YX040.
Informed consent statement: The patient's informed consent has been obtained in this case.
Conflict-of-interest statement: The authors have no financial disclosures or conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yu-Li Li, PhD, Associate Professor, Plastic Surgery Institute of Weifang Medical University, Yuhe Campus of Weifang Medical University, No. 4948 Shengli East Street, Weifang 261042, Shandong Province, China. lily19791002@126.com
Received: January 20, 2021
Peer-review started: January 20, 2021
First decision: May 13, 2021
Revised: May 19, 2021
Accepted: July 6, 2021
Article in press: July 6, 2021
Published online: August 26, 2021
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.

Keywords: Gastric glomus tumor, Laparoscopy, Gastroscopy, Immunohistochemical staining, Operation method, Case report

Core Tip: Gastric glomus tumors (GGTs) lack specific clinical and endoscopic features. They are often mistaken as common gastrointestinal stromal tumors (GISTs), which means that they are difficult to diagnose preoperatively. Whereas laparoscopic resection can be performed in traditional surgery, it is difficult to accurately determine the location of the region growing into the cavity. Surgery is traumatic and invasive and can cause related complications. This paper presents a case of GGT that was removed by laparoscopy-gastroscopy cooperative surgery. We also reviewed the literature on computed tomography findings and traditional surgical methods of GISTs and GGTs.