Rare Gastric Neoplasm: Malignant Glomus Tumor of The Stomach. A Case Report

Abstract Introduction Glomus tumors are rare neoplasms arising from neuromyoarterial canal or glomus body. They are mainly found in the peripheral soft tissue, extremities and rarely developed inside the gastrointestinal tract (GIT). In the GIT, the stomach is the most common site for the development of GTs, and most often found in the antrum. GGTs symptoms are usually non specific i.e (abdominal pain, GI bleeding and/or perforation) and may also be found incidentally during upper GI endoscopy. Case presentation This is a 56 year old male, presented to the emergency department with upper GI bleeding i.e (melema), with signs of shock (HR: 110; BP:80/60), Blood tests showed Hemoglobin level 5 g/dl. Resuscitation started with IV fluid and transfusion of 4 units of PRBCs. After resuscitation, He gave a 10 days history of passing black tarry stool, palpitation, headache, dizziness, easily fatigability, malaise, and colicky epigastric abdominal pain. Abdomen exam was Soft, lax with no tenderness, there was fullness at the left upper quadrant. Upper GI endoscopy was performed showing proximal greater curvature large gastric ulcer with adherent clots, necrotic base and oozing, managed with heater probe, epinephrine injections and biopsy taken. The upper GI bleeding stopped after the endoscopy and his condition improved.The histopathology of the biopsy showed the top differential diagnosis is GIST but other submucosal lesions can not be excluded. He underwent exploratory laparotomy and wedge resection of the tumor. The final histopathology showed, a malignant glomus tumor. Clinical discussion Due to overlapping clinical and radiological features between glomus, GIST and other submucosal lesions, the histopathological examination is considered to be the gold standard for the diagnosis. Surgical resection with negative margin is the mainstay for the treatment of GGTs. Conclusion Although gastric glomus tumor is a rare entity and accounts for 1% of all gastric mesenchymal tumors, it should be considered in the differential diagnosis, since preoperative biopsy is difficult and overlapping features with other submucosal lesions. Surgical treatment is the preferred option for GGTs and long-term follow-up is required due to the high metastatic and recurrence rate in the malignant type.