Published online Oct 16, 2016. doi: 10.4253/wjge.v8.i18.674
Peer-review started: April 18, 2016
First decision: May 19, 2016
Revised: June 13, 2016
Accepted: August 11, 2016
Article in press: August 15, 2016
Published online: October 16, 2016
Plexiform angiomyxoid myofibroblastic tumor (PAMT) is a rare benign mesenchymal tumor of stomach. Rarity of this kind of tumors and scarce review articles may cause underrecognition of this entity and pose a real diagnostic challenge to gastroenterologists, pathologists and surgeons when encountering such patients and differentiating PAMT from other gastric intramural tumors. We report a case of 28-year-old woman, who presented with epigastric pain after meals, iron-deficiency anaemia and weight loss. Upper gastrointestinal endoscopy revealed submucosal tumor-like elevated lesion in the anterior wall of the antrum with intact overlying mucosa. Endoscopic ultrasound showed a 3-cm hypoechoic homogenous mass, originating from the third layer of the gastric wall. Endoscopic ultrasound-guided fine needle aspiration was not informative. Endoscopic buttonhole biopsy was performed to obtain specimens. Following this, the unexpected prolapse of the tumor occurred into the lumen of the stomach, causing gastric outlet obstruction - the biopsy was obtained. Pathomorphological features suggested the diagnosis of PAMT. Gastric resection of the Billroth I type was performed. Diagnosis was confirmed by histological analysis of the surgical specimen.
Core tip: Plexiform angiomyxoid myofibroblastic tumor is a rare benign mesenchymal tumor of stomach. Rarity of this kind of tumors and scarce review articles may cause underrecognition of this entity and pose a real diagnostic challenge, when differentiating between various intramural lesions. Clinical signs and symptoms are nonspecific or absent, radiological features often overlap, upper gastrointestinal endoscopy has a limited role because of intramural location. Endoscopic ultrasound yields opportunity to visualize and biopsy the tumor. Definite diagnosis requires histological and immunohistochemical analysis.