Published online Jun 15, 2017. doi: 10.4251/wjgo.v9.i6.263
Peer-review started: October 25, 2016
First decision: March 8, 2017
Revised: March 22, 2017
Accepted: May 3, 2017
Article in press: May 5, 2017
Published online: June 15, 2017
A 66-year-old man was diagnosed with a gastric submucosal tumor. Endoscopic ultrasound (EUS) revealed an iso/hypoechoic mass in the third layer. No malignant cells were detected in a histological examination. Yearly follow-up endoscopy and EUS showed the slow growth of the tumor. Endoscopic submucosal dissection (ESD) was performed and a glistening tumor was resected. The lesion showed a multinodular plexiform growth pattern consisting of spindle cells with an abundant fibromyxoid stroma that was rich in small vessels. The tumor was diagnosed as plexiform fibromyxoma (PF) by immunohistochemistry. Although difficulties are associated with reaching a diagnosis preoperatively, chronological changes on EUS may contribute to the diagnosis of PF. ESD may also be useful in the diagnosis and treatment of PF.
Core tip: Plexiform fibromyxoma (PF) is a very rare gastric submucosal tumor. Therefore, difficulties are associated with diagnosing PF preoperatively, particularly in a differential diagnosis of gastrointestinal stromal tumors with cystic changes. We suggest that the chronological changes observed by endoscopic ultrasound contribute to the preoperative diagnosis of PF. Furthermore, endoscopic submucosal dissection needs to be considered for the diagnostic treatment of PF without muscle invasion.