Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2253
Peer-review started: August 9, 2021
First decision: October 17, 2021
Revised: October 25, 2021
Accepted: January 22, 2022
Article in press: January 22, 2022
Published online: March 6, 2022
Processing time: 204 Days and 14.4 Hours
Plexiform fibromyxoma (PF) is a rare mesenchymal tumor, with limited case reports worldwide. Common clinical symptoms are abdominal discomfort and bleeding signs, which frequently present slow-onset in reported cases. Herein, we report a case of gastric PF presenting as acute onset and with pyemia accom-panying tumor rupture. We resected the tumor as well as the distal gastric, bulbus duodeni and gallbladder for treatment in emergency surgery. Notably, before the onset of the disease, the patient received coronavirus disease 2019 (COVID-19) vaccines.
A 26-year-old man was admitted to our hospital, due to abdominal pain and fever after having received COVID-19 vaccines. Laboratory examination indicated severe sepsis. Computed tomography scan revealed a large mass in the abdomen. Deformation of the gastrointestinal tract was seen during gastroscopy. After failure of anti-infective treatment and symptoms of shock developed, he received an emergency surgery. We found a huge and partly ruptured mass, with thick purulence. Microscopically, the mass was composed of spindle cells with clarified cytoplasm, accompanied by myxoid stroma and arborizing blood vessels. Immunohistochemistry showed the tumor cells as positive for smooth muscle actin and succinate dehydrogenase subunit B but negative for DOG-1 and CD117. Finally, the patient was diagnosed with gastric PF and discharged from the hospital.
Gastric PF manifesting as tumor rupture combined with pyemia is rare. Timely surgery is critical for optimal prognosis.
Core Tip: Gastric plexiform fibromyxoma (PF) is a rare mesenchymal tumor, with limited reports worldwide. This may be the first case report worldwide of emergency surgery performed for ruptured gastric PF with severe infection, demonstrating the rarity of the symptoms of this disease. In addition, we noted that the patient had a history of coronavirus disease 2019 vaccination before the onset of the disease. We also conducted a database search of PubMed and Web of Science as of June 2021, determining the number of reported cases to be 134 worldwide. Some new cases and experiences are summarized in this report.