1. Herzen Moscow Cancer Research Institute, branch of National Medical Research Radiology Center (St. Petersburg, Russian Federation)

Abstract:Introduction Plexiform fibromyxoma (PFM) is a very rare gastric tumor, no more than 20 cases described in literature. PFM is a benign mesenchymal tumor, usually occurs in gastric antrum. PFM in pathology reports characterized as mixed-type tumor located in submucosal and mucosal layer of gastric wall., consists of smooth-muscle cells, located between plexiform stromal webs, positive for SMA and negative for CD 117, CD 34 and S-100 Objectives The main aims of presented clinical case is to identify typical endoscopic diagnostic sings of PFM and to evaluate possibilities of endoscopic treatment in such cases. Methods In 2016 in P. A. Herzen Cancer Research Institute one case of PFM was detected in asymptomatic 35 y. o. female patient. Multimodal endoscopic examination, consisted of white-light high definition (WLI-HD) endoscopy, narrow-band imaging with near focus (NBI-NF) and endoscopic ultrasonography (EUS) with 20MHz miniprobe, was performed for diagnostic purposes. For treatment of identified tumor endoscopic submucosal dissection (ESD) was implemented. Results Multimodal endoscopic examination data showed, that PFM characterized as ulcerated polypoid submucosal lesion in gastric antrum. Gastric pits in ulceration margins, clearly visible with NB-NF, are elongated, but not distorted, intrapapillary capillary loops are broadened, but regular-shaped. EUS showed moderate-hypoechoic tumor mass in mucosa and 1/3 of submucosa, not invading muscularis propria. On the basis of the diagnostic data results, gastric PFM was suspected. Since lesion characterized with superficial invasion, ESD was performed, tumor resected en bloc. Pathology and immunohistochemical examination of retrieved specimen confirmed PFM diagnosis. Conclusion Gastric plexiform fibromyxoma has a specific endoscopic and endosonographic features, helpful for differential diagnostics. If tumor invading only mucosa and submucosal layer of gastric wall, it is safe to perform ESD as a treatment choice.

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Full text is published :
Pirogov S.S., Sokolov V.V., Kaprin A.D., Volchenko N.N. et al. ENDOSCOPIC DIAGNOSTICS AND TREATMENT OF GASTRIC PLEXIFORM FIBROMYXOMA. Experimental and Clinical Gastroenterology Journal. 2017;140(04):117-120
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