Buscar en
Gastroenterología y Hepatología
Toda la web
Inicio Gastroenterología y Hepatología Plexiform fibromyxoma, a rare mesenchymal gastric tumor
Información de la revista
Vol. 41. Núm. 3.
Páginas 166-167 (Marzo 2018)
Descargar PDF
Más opciones de artículo
Vol. 41. Núm. 3.
Páginas 166-167 (Marzo 2018)
Scientific letter
DOI: 10.1016/j.gastrohep.2017.03.003
Acceso a texto completo
Plexiform fibromyxoma, a rare mesenchymal gastric tumor
Fibromixoma plexiforme, un tumor gástrico mesenquimal poco frecuente
Pedro Luis Gonzalez-Corderoa,
Autor para correspondencia

Corresponding author.
, Daniel Vara-Brenesa, María del Carmen Pecero-Hormigob, Jose María Mateos-Rodrígueza, Javier Molina-Infantea, Yvana Anavy Martínez Mateoc, Miguel Fernández-Bermejoa
a Department of Gastroenterology, Hospital San Pedro de Alcantara, Caceres, Spain
b Internal Medicine, Hospital San Pedro de Alcantara, Caceres, Spain
c General Surgery, Hospital San Pedro de Alcantara, Caceres, Spain
Información del artículo
Texto completo
Descargar PDF
Figuras (2)
Texto completo

Plexiform angiomyxoid myofibroblastic tumor, also known as plexiform fibromyxoma, is a novel rare entity of gastric mesenchymal tumors, typical of gastric antrum, and commonly causing mucosal ulceration with upper gastrointestinal bleeding and anemia, and effectively treated by complete surgical resection usually accomplished by distal gastrectomy.

We report one recent patient from our center meeting clinical and histopathologic criteria compatible with plexiform fibromyxoma.

A 37-year-old male patient with no history of interest was admitted with upper gastrointestinal bleeding with hemodynamic instability. A total of three esophago-gastro-duodenoscopies were performed and we could observe a five centimeter-violaceous lesion with antral location. At first it seemed like a blood clot, but later it was checked a greater consistency which was different than a blood clot and more similar to an antral vascular neoformation (Fig. 1)

Figure 1.

Endoscopic antral lesion.


Abdominal ultrasonography and abdominal contrast-enhanced computed tomography reported an irregular rounded heterogeneous lesion in gastric antrum and acute bleeding areas suggestive of hematoma, with a size of 5.8×4×5cm. However they could not check an underlying lesion or associated thickened gastric wall. After a new episode of hemodynamic instability, the patient underwent emergency surgical intervention with an antrectomy (Fig. 2). Postoperative period was uneventful and the patient was discharged on postoperative day 9.

Figure 2.

Surgical piece.


Histopathological examination revealed partial dense collagenous matrices and networks of fine capillary-caliber blood vessels. The tumor demonstrated lobular or fused nodular growth of spindle cells without atypical cytology, with abundant alcian blue-positive myxoid extracellular matrix. Hematoxylin and eosin staining showed lobulated or fused multinodular growth. Immunohistochemically it demonstrated an expression of muscle specific actin, desmin, and immunoexpression of CD10, and it was negative for CD31, CD34, VIII Factor, S100, Ckit, DOG1, HHV8, ALK, MDM2, CD23.

This pathological anatomy revealed a case of gastric plexiform fibromyxoma, an angio-myxoid plexiform myofibroblastic tumor which is a benign tumor that has recently been defined as a multinodular myxoid tumor with a peculiar plexiform growth pattern, myxoid stroma, prominent vasculature, and spindle cells with myofibroblastic differentiation.

This type of tumor was recently characterized by Takahashi et al.1 and Miettinen et al.,2 and 60 cases of plexiform fibromyxoma including the present case have been reported so far.3 According to previous reports, this tumor can occur at any age range, 7–75 years, typically middle age, and has a roughly equal gender distribution. The clinical presentation is generally similar to that of GISTs, with hematemesis being the most common symptom.4 In some rare cases, pyloric obstruction with weight loss may be noted. This tumor is predicted to exhibit benign biological behavior and there have been no reported cases of local recurrence or distant metastases after resection with a margin of normal tissue.

In conclusion, the current article reports a case of plexiform fibromyxoma, a rare mesenchymal gastric neoplasm that requires distinction from the others gastric mesenchymal tumors. Because of this, it is very important we know its symptoms, endoscopic and radiological images and its immunohistochemical in order to make an better diagnosis and treatment.

Y. Takahashi, S. Shimizu, T. Ishida, K. Aita, S. Toida, T. Fukusato, et al.
Plexiform angiomyxoid myofibroblastic tumor of the stomach.
Am J Surg Pathol, 31 (2007), pp. 724-728
M. Miettinen, H.R. Makhlouf, L.H. Sobin, J. Lasota.
Plexiform fibromyxoma: a distinctive benign gastric antral neoplasm not to be confused with a myxoid gist.
Am J Surg Pathol, 33 (2009), pp. 1624-1632
G. Quero, T. Musarra, A. Carrato, M. Fici, M. Martini, A.P. Dei Tos, et al.
Unusual focal keratin expression in plexiform angiomyxoid myofibroblastic tumor: a case report and review of the literature.
Medicine (Baltimore), (2016), pp. 95
A.M. Vallejo-Benítez, J. Suárez-Aguado, M. Mora-Cabezas, T. Aramendi, M. Gimeno, J. Salas, et al.
Fibromixoma plexiforme del antro gástrico: descripción de dos casos y revisión de la literatura.
Rev Esp Patol, 46 (2013), pp. 93-100
Copyright © 2017. Elsevier España, S.L.U.. All rights reserved
Opciones de artículo
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.