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Plexiform fibromyxoma, a rare mesenchymal gastric tumor
Fibromixoma plexiforme, un tumor gástrico mesenquimal poco frecuente
Pedro Luis Gonzalez-Corderoa,
Corresponding author
pelu7_8@hotmail.com

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
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Plexiform angiomyxoid myofibroblastic tumor&#44; also known as plexiform fibromyxoma&#44; is a novel rare entity of gastric mesenchymal tumors&#44; typical of gastric antrum&#44; and commonly causing mucosal ulceration with upper gastrointestinal bleeding and anemia&#44; and effectively treated by complete surgical resection usually accomplished by distal gastrectomy&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report one recent patient from our center meeting clinical and histopathologic criteria compatible with plexiform fibromyxoma&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A 37-year-old male patient with no history of interest was admitted with upper gastrointestinal bleeding with hemodynamic instability&#46; A total of three esophago-gastro-duodenoscopies were performed and we could observe a five centimeter-violaceous lesion with antral location&#46; At first it seemed like a blood clot&#44; but later it was checked a greater consistency which was different than a blood clot and more similar to an antral vascular neoformation &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Abdominal ultrasonography and abdominal contrast-enhanced computed tomography reported an irregular rounded heterogeneous lesion in gastric antrum and acute bleeding areas suggestive of hematoma&#44; with a size of 5&#46;8<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>cm&#46; However they could not check an underlying lesion or associated thickened gastric wall&#46; After a new episode of hemodynamic instability&#44; the patient underwent emergency surgical intervention with an antrectomy &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Postoperative period was uneventful and the patient was discharged on postoperative day 9&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Histopathological examination revealed partial dense collagenous matrices and networks of fine capillary-caliber blood vessels&#46; The tumor demonstrated lobular or fused nodular growth of spindle cells without atypical cytology&#44; with abundant alcian blue-positive myxoid extracellular matrix&#46; Hematoxylin and eosin staining showed lobulated or fused multinodular growth&#46; Immunohistochemically it demonstrated an expression of muscle specific actin&#44; desmin&#44; and immunoexpression of CD10&#44; and it was negative for CD31&#44; CD34&#44; VIII Factor&#44; S100&#44; Ckit&#44; DOG1&#44; HHV8&#44; ALK&#44; MDM2&#44; CD23&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">This pathological anatomy revealed a case of gastric plexiform fibromyxoma&#44; 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&#44; myxoid stroma&#44; prominent vasculature&#44; and spindle cells with myofibroblastic differentiation&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">This type of tumor was recently characterized by Takahashi et al&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> and Miettinen et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> and 60 cases of plexiform fibromyxoma including the present case have been reported so far&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> According to previous reports&#44; this tumor can occur at any age range&#44; 7&#8211;75 years&#44; typically middle age&#44; and has a roughly equal gender distribution&#46; The clinical presentation is generally similar to that of GISTs&#44; with hematemesis being the most common symptom&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> In some rare cases&#44; pyloric obstruction with weight loss may be noted&#46; 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&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion&#44; the current article reports a case of plexiform fibromyxoma&#44; a rare mesenchymal gastric neoplasm that requires distinction from the others gastric mesenchymal tumors&#46; Because of this&#44; it is very important we know its symptoms&#44; endoscopic and radiological images and its immunohistochemical in order to make an better diagnosis and treatment&#46;</p></span>"
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ISSN: 02105705
Original language: English
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es en pt

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

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