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• W3210213816 abstract "Introduction: Glomus tumors (GT) are benign lesions that arise from a dermal glomus body responsible for skin thermoregulation. Though clinically recognized as benign, these tumors can behave like malignant lesions. GT’s rarely involve visceral organs and make up less than 1% of gastrointestinal tumors. The gold standard for treatment of gastric GTs is wide local excision, with no identification of extended margins of resection. We report a case of a slow growing gastric mass (GM) initially diagnosed as a benign GI stromal tumor (GIST) and seven years later, identified as a gastric GT using EUS guided FNB. Case Description/Methods: A 72-year-old male was hospitalized for an upper GI bleed that was notable for a 1.5 cm bleeding gastric ulcer (BGU). Repeat EGD showed a 2 cm submucosal GM identified whose biopsy was non-diagnostic. It is unclear if this submucosal mass formed at the initial site of the BGU. Patient was offered surgical excision, but declined, and was subsequently lost to follow up. After 7 years, the patient was referred for a positive stool FIT. EGD at this time showed a non-bleeding 3 cm submucosal GM of the antral floor (Fig 1A). Initial biopsy showed mild foveolar hyperplasia. Patient was then referred for EUS, which was notable for a 2.5 x 1.9 cm submucosal antral tumor (Fig 1B). EUS-guided FNB was performed, and pathology identified a GT staining positively to calretinin (Fig 1C), KI-67, vimentin, and synaptophysin. Upon these findings, the patient was again offered surgical resection, but declined. Discussion: This case highlights the importance of utilizing EUS-guided FNB to accurately diagnose a slow-growing submucosal GM. This patient, initially hospitalized in 2013 with an upper GI bleed, remained asymptomatic for 7 years until he was referred for evaluation of a positive stool FIT. Patient denied all GI symptoms including abdominal pain, nausea, vomiting, change in bowel habits, melena, and unintentional weight loss. Though benign, GTs can follow a malignant growth pattern and may cause symptoms in an otherwise healthy patient. If symptomatic, treatment includes surgical excision, otherwise routine monitoring is not recommended.Figure 1.: A. Upper GI endoscopy showing a 1.5 cm polyp located along the greater curvature of the gastric body B. Microscopy of polyp showing smooth muscles interspersed between several glands (10x) C. Photomicrograph illustrating desmin-stained smooth muscle fibers with surrounding glandular tissue(10x)." @default.
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• W3210213816 date "2021-10-01" @default.
• W3210213816 modified "2023-09-27" @default.
• W3210213816 title "S3126 Gastric Glomus Tumor: A Rare Presentation of Upper GI Bleed" @default.
• W3210213816 doi "https://doi.org/10.14309/01.ajg.0000786036.20663.5f" @default.
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