Subscribe to RSS
DOI: 10.1055/a-2523-2575
Submucosal tunneling endoscopic resection of a rare gastric hemangioma
Gastric hemangioma is a rare gastric tumor, with its incidence reported to be 1.6% [1]. Gastrointestinal bleeding is one of its presenting symptoms [2]. Treatment was traditionally by surgical resection [3]. Recently, there have also been case reports of gastric hemangiomas being resected by endoscopic methods including endoscopic submucosal dissection (ESD) [4] [5]. Herein, we present a case of a gastric cavernous hemangioma being resected using submucosal tunneling endoscopic resection (STER).
A 73-year-old man underwent an upper gastrointestinal endoscopy for anemia (hemoglobin level 9 g/dL), which showed a 2-cm subepithelial lesion with bluish discoloration at the anterior antrum ([Fig. 1]). Endoscopic ultrasound (EUS) was subsequently performed and revealed that the lesion was at layer 3 and was showing heterogeneous echogenicity and suspected cystic spaces ([Fig. 2]). It was decided to proceed with endoscopic removal of the lesion using STER.
The entry of the tunnel was created around 3 cm proximal to the lesion. During the dissection along the tunnel, more vessels were encountered when getting closer to the lesion, with precoagulation of large vessels performed to help maintain a visible endoscopic field. A raspberry-like lesion was noted at the center of the lesion ([Video 1]). At this stage the procedure needed to be performed with caution as rupture of the cavernous hemangioma could have resulted in rapid blood flow and hemostasis in this situation can be difficult as the hemangioma can be further damaged when receiving thermal energy. The STER procedure was performed uneventfully. Histology revealed a hemangioma. The patient was discharged 2 days after the procedure. A follow-up endoscopy subsequently showed mucosal contraction on the healed wound ([Fig. 3]) and it was noted that the patient’s hemoglobin level had normalized to 13 g/dL.
Quality:
This case demonstrates that STER is feasible for gastric hemangiomas.
Endoscopy_UCTN_Code_TTT_1AQ_2AD_3AZ
E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy. All papers include a high-quality video and are published with a Creative Commons CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission process. We grant 100% waivers to articles whose corresponding authors are based in Group A countries and 50% waivers to those who are based in Group B countries as classified by Research4Life (see: https://www.research4life.org/access/eligibility/).
This section has its own submission website at https://mc.manuscriptcentral.com/e-videos.
Publication History
Article published online:
06 February 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
-
References
- 1 Minnes JR, Geschickter CF. Benign tumors of the stomach. Am J Cancer 1936; 28: 136-149
- 2 Bongiovi JJ, Duffy JL. Gastric hemangioma associated with upper gastrointestinal bleeding. Arch Surg 1967; 95: 93-98
- 3 Zong L, Chen P, Shi GH. et al. Gastric cavernous hemangioma: A rare case with upper gastrointestinal bleeding. Oncol Lett 2011; 2: 1073-1075
- 4 Arafa UA, Fujiwara Y, Shiba M. et al. Endoscopic resection of a cavernous haemangioma of the stomach. Dig Liver Dis 2002; 34: 808-811
- 5 Watanabe Y, Takahashi K, Yokoyama J. et al. Gastric cavernous hemangioma resected by endoscopic submucosal dissection. Intern Med 2018; 57: 2269-2270