Abstract
Gastric glomus tumor (GGT) is a rare mesenchymal neoplasm with nonspecific clinical and imaging features, often leading to preoperative misdiagnosis. Its longitudinal imaging evolution remains poorly characterized. Herein, we report a 51-year-old man with a GGT in the gastric antrum who underwent 6-year multimodal imaging follow-up, including CT, MRI, and serial endoscopic ultrasonography (EUS). The lesion presented as a well-circumscribed subepithelial nodule with marked and persistent enhancement on CT. It showed slightly low signal intensity on T1-weighted imaging, slightly high signal intensity on T2-weighted imaging, and mild early arterial enhancement followed by persistent marked enhancement on dynamic contrast-enhanced MRI. Over the 6-year follow-up, the lesion showed an overall increase in size and a transition from a homogeneous to a heterogeneous hypoechoic appearance on serial EUS. It was initially misdiagnosed as a gastrointestinal stromal tumor. Histopathology confirmed the diagnosis of GGT. This case highlights that GGT may exhibit characteristic yet dynamic imaging features on long-term follow-up. Recognition of these features across modalities may improve preoperative diagnostic accuracy.