A case of gastric glomus tumor with metachronous liver metastasis after laparoscopic partial gastrectomy.

INTRODUCTION AND

IMPORTANCE

Gastric glomus tumor (GGT) is a rare submucosal mesenchymal tumor that is typically benign. However, GGT recurrence or metastasis has been reported.

CASE PRESENTATION: A 55-year-old man was referred to our hospital for gastric submucosal tumor (SMT) examination. Esophagogastroduodenoscopy revealed a 15 mm SMT in the anterior wall of the gastric antrum. Endoscopic ultrasonography demonstrated a hypoechoic solid mass that invaded the proper muscle layer. In contrast-enhanced abdominal computed tomography (CT), the anterior wall of the gastric antrum was thickened. Our provisional diagnosis was gastric leiomyoma. As the tumor grew rapidly, we performed laparoscopic partial gastrectomy. Histopathology revealed solid proliferation of tumor cells with oval-shaped nuclei. Immunohistochemically, the tumor cells were positive for alpha-smooth muscle actin and vimentin but negative for c-kit, CD34, desmin, and S-100. The MIB-1 labeling index was approximately 60 %. We then diagnosed the patient with GGT. After 2 years and 6 months, abdominal CT revealed metastatic lesions over 40 mm in diameter, with ring enhancement seen in segment 8 of the liver and another liver metastatic lesions 15 mm observed in segment 5/6. After being diagnosed with liver metastases of the GGT, the patient continued to receive chemotherapy for 26 months and was in good general condition.

CLINICAL DISCUSSION: Laparoscopic partial gastrectomy was performed for a rare GGT, revealing a case of asynchronous liver metastasis.

CONCLUSION

We managed a case of asynchronous liver metastasis of GGT.