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Gastric Plexiform Fibromyxoma

  • Sudeep Banerjee
  • Jorge de la Torre
  • Adam M. Burgoyne
  • Ann M. Ponsford Tipps
  • Thomas J. Savides
  • Jason K. SicklickEmail author
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Case Presentation

A 65-year-old male with past medical history of hypertension, hyperlipidemia, diabetes mellitus type 2, and adrenal cortical carcinoma presented to a local hospital for symptomatic anemia requiring multiple transfusions. After stabilization and discharge, the patient was referred to our institution for further evaluation and management of a suspected gastrointestinal stromal tumor (GIST). The patient reported 6 months of early satiety and worsening dyspepsia refractory to proton pump inhibitor therapy. Abdominal computed tomography (CT) showed a 5.0-cm mass in the stomach (Fig.  1a, b). He underwent esophagogastroduodenoscopy (EGD) and endoscopic ultrasound (EUS) revealing a 5.0 × 2.3 cm poorly defined, bilobar hypoechoic mass in the gastric antrum that arose from the muscularis propria (Fig. 1c, d). Immunohistochemistry (IHC) of the core needle biopsy revealed strongly positive staining for smooth muscle actin (SMA), weakly positive staining with CD117 (c-KIT), and...

Keywords

Submucosal tumor Gastrointestinal stromal tumor Gastric mass Plexiform angiomyxoid myofibroblastic tumor 
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Notes

Financial Support

This work was supported by the Society for Surgery of the Alimentary Tract (SSAT) Mentored Research Award (S.B), UC San Diego GIST Research Fund (J.K.S.), NIH K08CA168999 (J.K.S.) and NIH R21CA192072 (J.K.S.).

Author Contributions

SB contributed to the acquisition, analysis, and interpretation of patient data and the drafting of the manuscript. He approves of the final version to be published. He agrees to be accountable for all aspects of the work in ensuring that questions related to any part of the work are appropriately investigated and resolved.

JdlT contributed to the acquisition, analysis, and interpretation of patient data and the drafting of the manuscript. He approves of the final version to be published. He agrees to be accountable for all aspects of the work in ensuring that questions related to any part of the work are appropriately investigated and resolved.

AMB contributed to the acquisition, analysis, and interpretation of patient data and the drafting of the manuscript. He approves of the final version to be published. He agrees to be accountable for all aspects of the work in ensuring that questions related to any part of the work are appropriately investigated and resolved.

AMPT contributed to the acquisition, analysis, and interpretation of patient data and the drafting of the manuscript. He approves of the final version to be published. He agrees to be accountable for all aspects of the work in ensuring that questions related to any part of the work are appropriately investigated and resolved.

TJS contributed to the acquisition, analysis, and interpretation of patient data and the drafting of the manuscript. He approves of the final version to be published. He agrees to be accountable for all aspects of the work in ensuring that questions related to any part of the work are appropriately investigated and resolved.

JKS contributed to the acquisition, analysis, and interpretation of patient data and the drafting of the manuscript. He approves of the final version to be published. He agrees to be accountable for all aspects of the work in ensuring that questions related to any part of the work are appropriately investigated and resolved.

Compliance with Ethical Standards

Conflict of Interest

Jason Sicklick receives research funding from Novartis Pharmaceuticals, Amgen Pharmaceuticals, and Foundation Medicine, as well as consultant fees from Biotheranostics. J.K.S. also serves or served as consultant to the following organizations: Grand Rounds (2015–2018) and Loxo Oncology (2017–2018). These disclosures had no impact on any of the work presented in this manuscript. No other authors have any conflict of interests to declare.

References

  1. 1.
    Szurian, K. et al. Rarity among benign gastric tumors: Plexiform fibromyxoma - Report of two cases. World journal of gastroenterology 23, 5817–5822, doi: https://doi.org/10.3748/wjg.v23.i31.5817 (2017).CrossRefPubMedPubMedCentralGoogle Scholar
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    Miettinen, M., Makhlouf, H. R., Sobin, L. H. & Lasota, J. Plexiform Fibromyxoma: A Distinctive Benign Gastric Antral Neoplasm Not to be Confused With a Myxoid Gist. The American journal of surgical pathology 33, 1624–1632, doi: https://doi.org/10.1097/PAS.0B013E3181AE666A (2009).CrossRefPubMedGoogle Scholar
  3. 3.
    Morris, M. W., Sullivan, L., Sawaya, D. E., Steiner, M. A. & Nowicki, M. J. Gastric plexiform fibromyxoma tumor in a child – Case report and review of the literature. Journal of Pediatric Surgery Case Reports Volume 4, Pages 38–41 (2016).CrossRefGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  • Sudeep Banerjee
    • 1
    • 2
  • Jorge de la Torre
    • 1
  • Adam M. Burgoyne
    • 3
  • Ann M. Ponsford Tipps
    • 4
  • Thomas J. Savides
    • 5
  • Jason K. Sicklick
    • 1
    Email author
  1. 1.Division of Surgical Oncology, Department of Surgery, Moores Cancer CenterUniversity of California, San DiegoLa JollaUSA
  2. 2.Department of Surgery, David Geffen School of MedicineUCLALos AngelesUSA
  3. 3.Division of Hematology Oncology, Department of Medicine, Moores Cancer CenterUniversity of California, San DiegoLa JollaUSA
  4. 4.Division of Anatomic Pathology, Department of PathologyUniversity of California, San DiegoLa JollaUSA
  5. 5.Division of Gastroenterology, Department of MedicineUniversity of California, San DiegoLa JollaUSA

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