A Case of Small Intestine Glomus Tumor Detected by Obscure Gastrointestinal Bleeding of Indeterminate Origin

Abstract

A 65-year-old woman complaining of melena was found to have severe anemia by a blood test at a nearby hospital. Upper GI endoscopy and colonoscopy showed no bleeding lesion but enhanced CT revealed a strongly-enhanced tumor in the small intestine. We used capsule endoscopy and double balloon endoscopy to examine the small intestine and detected a 20-mm submucosal-tumor like mass with erosion and depression in the lower jejunum. Under a diagnosis of gastrointestinal stromal tumor in the jejunum associated with GI bleeding, laparoscopy-assisted partial resection of the small intestine was performed. Histopathological and immunohistological examinations revealed a glomus tumor in the small intestine with an intermediate malignancy. Glomus tumors arising from the GI tract are rate and most of them are originated from the stomach. There was no report of glomus tumor in the small intestine from Japan and were only two such case reports in the English literature, thus highlighting the extreme rarity of this clinical entity.