胃Glomus腫瘍の1例

A CASE OF GLOMUS TUMOR OF THE STOMACH

Ⅰ．はじめに

　胃に生じたGlomus腫瘍はまれにみる疾患で，その報告例はきわめて少なく，1951年，Kayら¹⁾によって第1例が報告されて以来，著者らが内科の文献を渉猟したところによると，外国文献では，1964年，Schneider²⁾の報告までで25例，本邦では，1962年，庄司³⁾による第1例，次いで1967年までに，高橋ら⁴⁾，高橋ら⁵⁾，光安⁶⁾，勝ら⁷⁾，桂ら⁸⁾，岡本⁹⁾，鮫島ら¹⁰⁾，柏木¹¹⁾と計9例の報告がみられるにすぎない．

　著者らは，このたび胃Glomus腫瘍の1例を経験したので，本邦第10例目の症例として報告する．あわせて，内視鏡像について若干の見解を述べる．

　Glomus tumor of the stomach is a very rare occurrence. According to the authors' investigation regarding the literature on this subject, both abroad and at home, only 25 cases in the foreign countries and 9 cases in this country have ever been reported so far. In this paper is described a case of glomus tumor of the stomach associated with two ulcer lesions (Ul-Ⅲ).

　The patient is a 40 years old man with epigastric pain as his chief complaint. At the time of admission, no occult blood was found in the feces, nor was he anemic and the gastric juice showed hyperacidity. As a submucosal tumor of the stomach concomitant with two ulcers was discovered at x-ray and GTF examinations, gastrectomy was performed.

　The tumor, 42 × 35 × 29 in size, with elastic soft consistency, was located in the greater curvature side of the pyloric antrum. It was a well circumscribed tumor in the muscle layer, looking like a sponge on its cut section. Histological study of the neoplasm disclosed that it consisted of various, irregular-sized vascularity with pale tumor cells surrounding it. Silver-stained specimens shows that these cells are positive for argyrophil fibril but negative for argentalfin granule by Fontana's siver-staining method.

　In this country only three cases of glornus tumor of the stomach have ever been studied by endoscopy. One of the aims of this report is to grasp its gross characteristics of 34 in all of resected specimens as exactly as possible so that the endoscopic diagnosis of the glomus tumor of the stomach might be the better facilitated by finding some common diagnostic features.

　At all events, there exist no pathognomonic features of glomus tumor. It has been experienced, however, that its qualitative diagnosis is in some measure attainable when its size as well as its preferential site and the external aspects of the tumor are carefully studied to the exclusion of all other protruded lesions of the stomach.