Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2015; 21(22): 7052-7058
Published online Jun 14, 2015. doi: 10.3748/wjg.v21.i22.7052
Diagnostic utility of endoscopic ultrasound-guided fine-needle aspiration biopsy for glomus tumor of the stomach
Shin Kato, Kaoru Kikuchi, Kenji Chinen, Takahiro Murakami, Fumihito Kunishima
Shin Kato, Kaoru Kikuchi, Kenji Chinen, Department of Gastroenterology, Okinawa Prefectural Chubu Hospital, Okinawa 904-2293, Japan
Takahiro Murakami, Department of Surgery, Okinawa Prefectural Chubu Hospital, Okinawa 904-2293, Japan
Fumihito Kunishima, Department of Pathology, Okinawa prefectural Chubu Hospital, Okinawa 904-2293, Japan
Author contributions: Kato S wrote the manuscript; Kato S, Chinen K and Murakami T managed the patient and performed the procedure; Kunishima F provided the figures and discussion of the pathology; Kikuchi K supervised the research; all authors approved the final manuscript for publication.
Ethics approval: This case report was reviewed and approved by Okinawa Prefectural Chubu Hospital Institutional Review Board.
Informed consent: The patient of this case provided informed consent prior to the procedure. The patient also approved to publish the case.
Conflict-of-interest: No potential conflict of interest relevant to this article was reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Shin Kato, MD, Department of Gastroenterology, Okinawa Prefectural Chubu Hospital, Miyazato 281, Uruma, Okinawa 904-2293, Japan. shinchan1231@gmail.com
Telephone: +81-98-9734111 Fax: +81-98-9732703
Received: January 8, 2015
Peer-review started: January 9, 2015
First decision: January 22, 2015
Revised: February 22, 2015
Accepted: April 3, 2015
Article in press: April 3, 2015
Published online: June 14, 2015
Processing time: 160 Days and 19.9 Hours
Abstract

A 52-year-old man was referred for further investigation of a gastric submucosal tumor on the greater curvature of the antrum. Endoscopic ultrasonography demonstrated a hypoechoic solid mass, which was primarily connected to the muscular layer of the stomach. We performed endoscopic ultrasound-guided fine-needle aspiration biopsy. The pathological examination showed proliferation of oval-shaped cells with nest formation, which stained strongly positive for muscle actin, and negative for c-kit, CD34, CD56, desmin, S-100, chromogranin, and neuron-specific enolase. Therefore, we performed laparoscopy and endoscopy cooperative surgery based on the preoperative diagnosis of glomus tumor of the stomach. The final histological diagnosis confirmed the preoperative diagnosis. Although preoperative diagnosis of glomus tumor of the stomach is difficult with conventional images and endoscopic biopsy, endoscopic ultrasound-guided fine-needle aspiration biopsy is an essential tool to gain histological evidence of glomus tumor of the stomach for early diagnosis.

Keywords: Glomus tumor; Endoscopic ultrasound-guided fine-needle aspiration biopsy; Stomach; Preoperative diagnosis

Core tip: Preoperative diagnosis of glomus tumor of the stomach is difficult as its exhibits a similar clinical appearance on conventional images (computed tomography, magnetic resonance imaging, endoscopic ultrasonography) to other submucosal tumors of the stomach. Furthermore, pathological evidence for diagnosis is difficult to obtain by conventional endoscopic biopsy. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is an essential and useful diagnostic tool for glomus tumor of the stomach to obtain pathological evidence including immunohistochemical staining which is critically important to diagnose pathologically. There are only eight literatures of gastric glomus tumors which were diagnosed by FNA. This is a first report to review these literatures.