Rare mesenchymal antral gastric tumors: Case reports of glomus tumor and plexiform fibromyxoma

Branco, Inês Vieites; Silva, João Carlos; Pinto, Flávia Santos Twardowski; Pires, Fernando Calejo; Almeida, Ana G.

doi:10.1016/j.radcr.2019.10.006

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…PFs have been reported as either case reports or small case series. To date, a total of 130 PF cases have been reported in the English literature[ 1 , 6 , 16 - 22 ]. Given the fact that only nineteen cases had been described by 2010 (approximately three years after the first description of the entity), this remarkable increase in its incidence in a short period of time may be attributable to the increased awareness of PF by clinicians and pathologists[ 1 , 7 ].…”

Section: History and Nomenclaturementioning

confidence: 99%

Plexiform fibromyxoma: Review of rare mesenchymal gastric neoplasm and its differential diagnosis

Arslan

et al. 2021

WJGO

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Plexiform fibromyxoma (PF) is a very rare mesenchymal neoplasm of the stomach that was first described in 2007 and was officially recognized as a subtype of gastric mesenchymal neoplasm by World Health Organization (WHO) in 2010. Histologically, PF is characterized by a plexiform growth of bland spindle to ovoid cells embedded in a myxoid stroma that is rich in small vessels. The lesion is usually paucicellular. While mucosal and vascular invasion have been documented, no metastasis or malignant transformation has been reported. Its pathogenesis is largely unknown and defining molecular alterations are not currently available. There are other mesenchymal tumors arising in the gastrointestinal tract that need to be differentiated from PF given their differing biologic behaviors and malignant potential. Histologic mimics with spindle cells include gastrointestinal stromal tumor, smooth muscle tumor, and nerve sheath tumor. Histologic mimics with myxoid stroma include myxoma and aggressive angiomyxoma. Molecular alterations that have been described in a subset of PF may be seen in gastroblastoma and malignant epithelioid tumor with glioma-associated oncogene homologue 1 ( GLI1 ) rearrangement. The recent increase in publications on PF reflects growing recognition of this entity with expansion of clinical and pathologic findings in these cases. Herein we provide a review of PF in comparison to other mesenchymal tumors with histologic and molecular resemblance to raise the awareness of this enigmatic neoplasm. Also, we highlight the challenges pathologists face when the sample is small, or such rare entity is encountered intraoperatively.

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Section: History and Nomenclaturementioning

confidence: 99%

Plexiform fibromyxoma: Review of rare mesenchymal gastric neoplasm and its differential diagnosis

Arslan

et al. 2021

WJGO

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“…To better understand the clinicopathologic features of PF, we performed a brief review of the literature (Table 1). 1–51 Taking the present study into account, the tumor is located mainly in the gastric antrum and pylorus (76%), but other rare locations, such as the gastric fundus, gastric body, duodenum, jejunum, cecum, gallbladder, posterior mediastinum, and esophagus, have also been reported. 2 , 17 , 29 , 47 The overall median and average ages of patients with PF at diagnosis were 46 years and 43.3 years, respectively (range, 5 to 81 years).…”

Section: Discussionmentioning

confidence: 69%

Plexiform fibromyxoma: a clinicopathological and immunohistochemical analysis of two cases with a literature review

Wang

et al. 2021

J Int Med Res

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Objective This article aimed to study the clinicopathological features, immunophenotypes, and differential diagnoses of plexiform fibromyxoma (PF). Methods We searched clinical and pathology databases of our hospital for patients with histologically confirmed PF from 2007 to 2020 and reviewed the relevant English and Chinese language literature. Results Two cases of PF were identified, a 67-year-old woman and a 23-year-old man. Both patients presented with melena and anemia and underwent partial gastrectomy. Histologically, the tumors exhibited a plexiform growth pattern in the gastric submucosa and the presence of bland-looking spindle cells in the fibromyxoid stroma with the formation of small blood vessels. Immunohistochemically, the two cases were strongly positive for vimentin, smooth muscle actin, and muscle-specific actin and negative for CD117, discovered on gastrointestinal stromal tumors protein 1, CD34, CD10, S100, desmin, H-caldesmon, estrogen receptor, progesterone receptor, β-catenin, and cytokeratin. Conclusions PF is a rare mesenchymal tumor of the stomach that can be distinguished from other gastrointestinal mesenchymal tumors based on its distinctive morphology and immunophenotype.

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“…Coincidentally, this enhanced CT performance is consistent with a recent case report of GGT. 23 Previous research has shown that necrosis and surface ulceration are common in patients with large GSTs (47.5% [47/99] and 40.4% [40/99], respectively). 18 In fact, necrosis, calcification, and surface ulceration were rarely found and showed no significant difference between these two groups in the present study, which may be attributed to their small diameter.…”

Section: Ct Criteriamentioning

confidence: 99%

Differentiation of gastric glomus tumor from small gastric stromal tumor by computed tomography

Wang

Liu

et al. 2020

J Int Med Res

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Objective This study was performed to investigate the value of computed tomography (CT) in the differentiation of gastric glomus tumors (GGTs) and small gastric stromal tumors (GSTs). Methods Fifty-nine patients with pathologically confirmed GGTs (n = 11) and GSTs (n = 48) from 2006 to 2019 were retrospectively evaluated. All patients’ preoperative CT imaging features were analyzed. Results The following features were significantly different between GGTs and small GSTs: location in the antrum, endophytic growth, heterogeneous enhancement in the arterial phase, CT value in the arterial phase of ≥60.7 Hounsfield units (HU), CT value in the portal phase of ≥87.6 HU, degree of enhancement in the arterial phase of ≥29.9 HU, and degree of enhancement in the portal phase of ≥49.0 HU. A model including four randomly selected features among these seven criteria was built to differentiate GGTs from small GSTs with a sensitivity and specificity of 90.9% (10/11) and 100% (48/48), respectively. Conclusion We identified seven features that are useful for differentiating GGTs from small GSTs. A combination of four of these seven criteria may increase the diagnostic accuracy.

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Rare mesenchymal antral gastric tumors: Case reports of glomus tumor and plexiform fibromyxoma

Cited by 6 publications

References 6 publications

Plexiform fibromyxoma: Review of rare mesenchymal gastric neoplasm and its differential diagnosis

Plexiform fibromyxoma: Review of rare mesenchymal gastric neoplasm and its differential diagnosis

Plexiform fibromyxoma: a clinicopathological and immunohistochemical analysis of two cases with a literature review

Differentiation of gastric glomus tumor from small gastric stromal tumor by computed tomography

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