Case Report: Synchronous gastric glomus tumor and gastrointestinal stromal tumor identified in the same gastric region

Gastric glomus tumors and gastrointestinal stromal tumors are uncommon gastric mesenchymal tumors that may present as subepithelial or gastric-wall lesions, making preoperative diagnosis challenging. We report a woman in her early 70 s who was admitted after a gastric mass was incidentally detected during routine physical examination. Magnetic resonance imaging and contrast-enhanced computed tomography showed a 3.8–4.3 cm heterogeneously enhanced gastric-wall or extraluminal mass adjacent to the lesser curvature, and a gastric stromal tumor was suspected. However, gastroscopy revealed only a 1.5 cm smooth intraluminal submucosal lesion at the gastric angle. The patient underwent combined laparoscopic and endoscopic surgery based on the available imaging and endoscopic findings. Endoscopic submucosal dissection was performed for the intraluminal lesion, and laparoscopic resection was performed for the larger gastric-wall mass. Histopathological and immunohistochemical examination of two separately submitted specimens confirmed a gastric glomus tumor and a low-risk gastric GIST identified in the same gastric region. Their precise spatial relationship could not be established from the separately submitted specimens. The postoperative course was uneventful. At telephone follow-up approximately 6 months after surgery, the patient reported no obvious gastrointestinal symptoms but had not completed the recommended objective surveillance. She was subsequently lost to follow-up; therefore, no endoscopic or radiological follow-up data were available. This case illustrates the value of correlating imaging, endoscopic, operative, and pathological findings in gastric mesenchymal tumors. Radiologic–endoscopic size discordance is nonspecific and does not by itself establish the presence of two lesions.