Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2016; 8(18): 674-678
Published online Oct 16, 2016. doi: 10.4253/wjge.v8.i18.674
Plexiform angiomyxoid myofibroblastic tumor of stomach: A rare case
Laimas Jonaitis, Mindaugas Kiudelis, Paulius Slepavicius, Lina Poskienė, Limas Kupcinskas
Laimas Jonaitis, Paulius Slepavicius, Limas Kupcinskas, Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, 50009 Kaunas, Lithuania
Mindaugas Kiudelis, Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, 50009 Kaunas, Lithuania
Lina Poskienė, Department of Pathological Anatomy, Medical Academy, Lithuanian University of Health Sciences, 50009 Kaunas, Lithuania
Author contributions: Jonaitis L carried out the investigations, medical therapy and follow-up of the patient; Kiudelis M performed the surgery; Poskienė L made histological examination; Jonaitis L, Slepavicius P prepared the manuscript; all authors were involved in drafting and revising the manuscript.
Institutional review board statement: The study was reviewed and approved by the Lithuanian University of Health Sciences Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Laimas Jonaitis is a member of the World Journal of Gastrointestinal Endoscopy Editorial Board. Mindaugas Kiudelis, Lina Poškienė, Paulius Slepavicius, Limas Kupcinskas declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Laimas Jonaitis, MD, PhD, Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50009 Kaunas, Lithuania. laimasj@takas.lt
Telephone: +370-37326264 Fax: +370-37331458
Received: April 14, 2016
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
Processing time: 182 Days and 16.7 Hours
Abstract

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.

Keywords: Plexiform angiomyxoid myofibroblastic tumor; Intramural; Mesenchymal; Submucosal; Antrum

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.