Cavernous Gastric Hemangioma as an Unusual Cause of Upper Gastrointestinal Bleeding in a Young Woman

• Type of Material: Article
• Authors: Andrew Sun, Emory University; Jeffrey Sun, Imperial College London; Cheuk-Kay Sun, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
• Language: English
• Date: 2022-01-10
• Publisher: Karger Publishers
• Publication Version: Final Published Version
• Copyright Statement: © 2022 by S. Karger AG, Basel
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1159/000520624
• Title of Journal or Parent Work: Case Reports in Gastroenterology
• Volume: 16
• Issue: 1
• Start Page: 1
• End Page: 7
• Grant/Funding Information: This manuscript did not receive any funding.
• Keywords: Gastrointestinal bleeding; Gastric cancer; Case report; Esophagogastroduodenoscopy; Cavernous gastric hemangioma; Gastrectomy
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Gastric hemangiomas (GHs) are extremely rare vascular lesions of mesodermal origin that may occur in isolation or in conjunction with underlying congenital pathology. Due to the scarcity of these tumors, there is no standardized diagnostic method; however, many have found the combination of endoscopic investigation and radiographic imaging to be most effective, with the presence of phleboliths on computerized tomography as being pathognomonic for GHs. Surgical treatment for symptomatic lesions is curative with no reports of recurrence. We describe a 21-year-old woman who presented with epigastric pain and one episode of 250 mL hematemesis earlier that morning. Under the impression of an upper gastrointestinal bleed due to peptic ulcer disease, esophagogastroduodenoscopy was performed which revealed a 5-cm blood clot-like mass similar in appearance to that of a II-b peptic ulcer, but the presence of a bridging fold led to the suspicion of a possible submucosal tumor. Dynamic computerized tomography scan showed similar findings, and the patient was referred for surgical intervention. Laparoscopic distal gastrectomy was performed with the final diagnosis of cavernous GH made via histological evaluation. The patient was discharged 9 days later with no complications. This case puts emphasis on the importance of considering cavernous GH as a potential cause of severe upper GI bleeding especially in those with atypical demographic profile and history.