AUTHOR=Xia Ziqin , Zhou Zhidai , Guo Wei , Wang Hongling , Wang Fan , Zhou Feng 

TITLE=Endoscopic submucosal excavation for gastric plexiform fibromyxoma: A case report and systematic review of literature

JOURNAL=Frontiers in Oncology

VOLUME=Volume 13 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1090259

DOI=10.3389/fonc.2023.1090259

ISSN=2234-943X

ABSTRACT=Plexiform fibromyxoma (PF) is a rare mesenchymal tumor of which the pathogenesis and molecular changes are still unclear. Histologically, it is characterized by a cluster of bland spindle or ovoid cells growing in the mucoid or fibromyxoid stroma rich in small blood vessels. At present, surgical resection is the primary treatment for PF; In our case, upper gastrointestinal endoscopy of a 45-year-old woman patient revealed a 7.7mm submucosal tumor (SMT) on the small curvature side of the gastric antrum, but there was nothing found on contrast-enhanced computed tomography. On endoscopic ultrasonography, it showed a clear gastric wall and a hypoechoic lesion located in the gastric submucosa. Therefore, we considered it as a benign small SMT and subsequently performed endoscopic submucosal excavation (ESE). Immunohistochemical staining indicated that the tumor was positive for vimentin, CD34, and SDHB but negative for smooth muscle actin (SMA), desmin, DOG-1, CD117, cytokeratin, ALK-1, and S-100 protein. Approximately 2% of the tumor cells expressed the proliferation marker Ki-67. Finally, we diagnosed the tumor as a plexiform fibromyxoma, and performed a systematic review of the literature to better understand this pathology to design the most appropriate treatment and follow-up strategy for patients with PF.