A rare case of pancreatic glomangiomyoma diagnosed by endoscopic ultrasound-guided fine-needle aspiration

A 67-year-old woman presented with a 3-month history of upper abdominal pain. No positive result was found in tumor markers and antinuclear antibodies. Magnetic resonance imaging (MRI) detected a 15 × 11-mm mass with a T1W low signal and T2W high signal, which was enhanced in the arterial phase and weakened in the delayed phase. Endoscopic ultrasound (EUS) revealed a 14 × 12-mm hypoechoic lesion with a heterogeneous echo and a few stripe hyperechoic tissues. Ultrasound elastography imaging was primarily dominated by yellow-green tones interspersed with small areas of red and blue hues. Contrast-enhanced ultrasound showed heterogeneous enhancement in the arterial phase that receded quickly in the venous phase. The specimens were obtained by EUS-guided fine needle aspiration (FNA) with a 22G puncture needle of wet suction. Pathological examination revealed round tumor cells with SMA(+), Syn(–), Ki67 (3%+), CD34 (vascular+), consistent with the characteristics of a glomangiomyoma ([Fig. 1]).