Malignant gastric glomus tumor with heterochronous liver metastases: a case report and review of the literature.

Abstract

Background: Glomus tumors are mesenchymal tumors originating from the neuromuscular arterial canal or vascular lumen. While most gastric glomus tumors are benign and solitary, rare cases can be malignant and have a poor prognosis. Definitive treatment options remain limited for multifocal metastases, often necessitating salvage therapy.

Case presentation: A 36-year-old Han Chinese female patient presented with hematemesis, melena, and syncope persisting for four days. Diagnostic evaluations revealed a malignant gastric glomus tumor, prompting radical resection. During follow-up, radiological imaging identified liver metastases. Subsequent management included radiofrequency ablation and laparoscopic resection of select lesions.

Conclusions: Gastric glomus tumors pose diagnostic challenges owing to radiological and pathological features that overlap with gastrointestinal stromal tumors. Immunohistochemistry remains critical for definitive diagnosis. While Folpe's criteria for malignant gastric glomus tumors have limitations, they provide a practical framework. Our findings suggest that surgical resection followed by radiofrequency ablation may offer effective local control for recurrent or metastatic gastric glomus tumors. Further research is warranted to explore targeted therapies based on molecular profiling.