Endoscopic diagnosis and treatment of gastric glomus tumors

Background: Although gastric glomus tumors are usually benign lesions, occasional malignant transformation has been reported. Thus, complete resection of the gastric glomus tumor is necessary.

Objective: To provide a better understanding of the endoscopic features of this rare entity with an emphasis on its diagnosis and treatment.

Design: Retrospective case series.

Setting: Academic medical center.

Patients: Six patients (2 men, 4 women; median age 48 years) received a diagnosis of gastric glomus tumor and were treated.

Interventions: Endoscopic diagnosis and resection.

Main outcome measurements: Endoscopic features, resection success, adverse events, and follow-up endoscopy.

Results: Gastric glomus tumors do not exhibit specific features on gastroscopy and EUS that distinguish them from other gastric submucosal tumors. Endoscopic submucosal enucleation was successful in 5 patients. In one patient, the operation had to be discontinued because of significant bleeding during the procedure. The mean tumor size was 19.8±6.2 mm (range 12-30 mm). Perforation occurred in 1 patient and was successfully managed with hemoclips. No local recurrence was observed during follow-up (mean duration 9±5.1 months, range 3-17 months).

Limitations: Small number of patients (N=6), limited follow-up, retrospective study.

Conclusions: Diagnosis of gastric glomus tumors is difficult when based only on features derived from gastroscopy and EUS. Endoscopic submucosal enucleation is a feasible and safe procedure with which to diagnose and treat this lesion. However, further investigation and comparative studies are required to confirm the safety and efficacy of this method.