胃glomus腫瘍の1例

Glomus Tumor of the Stomach, Report of a Case

要旨　glomus腫瘍は，一般的には四肢末端の皮下や爪下に有痛性腫瘤として発生する良性腫瘍である．今回われわれは，極めてまれな胃glomus腫瘍の1例を経験した．患者は56歳女性．心窩部不快感を主訴として当科へ入院．胃X線および内視鏡検査より，胃前庭部小彎に表面平滑な球状の隆起性病変を認め，bridging foldを伴っていた．胃粘膜下腫瘍と診断し手術を施行．切除標本では腫瘍は，大きさ2.5×2.5×2.Ocmで，被膜に覆われ，固有筋層から圧排性に発育していた．病理組織学的に胃glomus腫瘍と診断された．われわれの症例を報告すると共に，これまで本邦で報告された胃glomus腫瘍32例についての文献的考察を加えた．

　The patient, a 56 year-old woman, was admitted to our hospital with epigastric discomfort. Examination of upper gastrointestinal series and gastric endoscopy showed a round protuberant tumor on the lesser curvature of the antrum (Fig. 1, 2). A diagnosis of gastric submucosal tumor was made, and gastrectomy was performed. The resected specimen disclosed a well encapsulated, firm, intramural tumor measuring 2.5×2.5×2.0 cm (Fig. 3). Histological examinations showed uniformly appearing tumor cells, which were in compact masses around variously dilated thin-walled vessels (Fig. 4a, b). Tumor cells were surrounded with argyrophil fibers (Fi. 4c). Histologically this tumor was diagnosed as glomus tumor of the stomach. The postoperative course was uneventful. The glomus tumor is a well-recognized benign entity and usually occurs in the skin of the extremities with paroxysmal lancinating pain. In addition to the skin, glomus tumors have been described in various other situations, and rare instances of their occurrence in the stomach have been reported. In this report we present a case of glomus tumor of the stomach and review thirty two cases reported in Japan.