Plexiform fibromyxoma with cotyledon‑like serosal growth: A case report of a rare gastric tumor and review of the literature

Kane,Joshua Robert; Lewis,Natasha; Lin,Rebecca; Villa,Celina; Larson,Alexandra; Wayne,Jeffrey D.; Yeldandi,Anjana   V.; Laskin,William B.

doi:10.3892/ol.2016.4185

Plexiform fibromyxoma with cotyledon‑like serosal growth: A case report of a rare gastric tumor and review of the literature

Authors:
- Joshua Robert Kane
- Natasha Lewis
- Rebecca Lin
- Celina Villa
- Alexandra Larson
- Jeffrey D. Wayne
- Anjana V. Yeldandi
- William B. Laskin
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Affiliations: Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
Published online on: February 4, 2016 https://doi.org/10.3892/ol.2016.4185
Pages: 2189-2194

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Abstract

Plexiform fibromyxoma is a rare, benign mesenchymal neoplasm that predilects the gastric antrum and has potential for misdiagnosis as a gastrointestinal stromal tumor (GIST). The histology of the tumor is characterized by interwoven fascicular growth of cytologically bland spindled cells within a variably myxoid stroma. The current study reports the clinicopathological and immunohistochemical findings of a plexiform fibromyxoma resected from a 28‑year‑old Vietnamese female. The patient presented with acute, severe abdominal pain and worsening anemia. The initial fine‑needle aspiration and needle core biopsy of the gastric antral mass led to an initial diagnosis of GIST. The subsequent distal partial gastrectomy revealed a 5.5‑cm transmural antral mass that ulcerated the overlying mucosa and grew as variably elongated, myxoedematous, polypoid (cotyledon‑like) excrescences from the serosal surface. Microscopically, the tumor demonstrated plexiform and multinodular growth of cytologically bland spindled cells proliferating in an abundant myxocollagenous stroma with a prominent capillary network. Tumor cells immunohistochemically expressed smooth muscle actin and CD10, but did not express CD117, Discovered on GIST‑1 or nuclear β‑catenin. Follow‑up evaluation 23 months post surgery revealed no evidence of residual tumor. A review the cases of this rare entity reported in the English language literature is also provided.

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