Scientific letter
Plexiform fibromyxoma, a rare mesenchymal gastric tumor
Fibromixoma plexiforme, un tumor gástrico mesenquimal poco frecuente
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array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific letter</span>" "titulo" => "Plexiform fibromyxoma, a rare mesenchymal gastric tumor" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "166" "paginaFinal" => "167" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Pedro Luis Gonzalez-Cordero, Daniel Vara-Brenes, María del Carmen Pecero-Hormigo, Jose María Mateos-Rodríguez, Javier Molina-Infante, Yvana Anavy Martínez Mateo, Miguel Fernández-Bermejo" "autores" => array:7 [ 0 => array:4 [ "nombre" => "Pedro Luis" "apellidos" => "Gonzalez-Cordero" "email" => array:1 [ 0 => "pelu7_8@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Daniel" "apellidos" => "Vara-Brenes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "María del Carmen" "apellidos" => "Pecero-Hormigo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Jose María" "apellidos" => "Mateos-Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Javier" "apellidos" => "Molina-Infante" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Yvana Anavy" "apellidos" => "Martínez Mateo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 6 => array:3 [ "nombre" => "Miguel" "apellidos" => "Fernández-Bermejo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Gastroenterology, Hospital San Pedro de Alcantara, Caceres, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Internal Medicine, Hospital San Pedro de Alcantara, Caceres, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "General Surgery, Hospital San Pedro de Alcantara, Caceres, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fibromixoma plexiforme, un tumor gástrico mesenquimal poco frecuente" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1219 "Ancho" => 1626 "Tamanyo" => 313576 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Surgical piece.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">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.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report one recent patient from our center meeting clinical and histopathologic criteria compatible with plexiform fibromyxoma.</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. 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 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>)</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, with a size of 5.8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>cm. 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 (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Postoperative period was uneventful and the patient was discharged on postoperative day 9.</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. 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.</p><p id="par0030" class="elsevierStylePara elsevierViewall">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.</p><p id="par0035" class="elsevierStylePara elsevierViewall">This type of tumor was recently characterized by Takahashi et al.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> and Miettinen et al.,<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.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> 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.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a> 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.</p><p id="par0040" class="elsevierStylePara elsevierViewall">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.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1192 "Ancho" => 1300 "Tamanyo" => 211896 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Endoscopic antral lesion.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1219 "Ancho" => 1626 "Tamanyo" => 313576 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Surgical piece.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Plexiform angiomyxoid myofibroblastic tumor of the stomach" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. 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| 2021 November | 38 | 4 | 42 |
| 2021 October | 38 | 7 | 45 |
| 2021 September | 28 | 10 | 38 |
| 2021 August | 56 | 12 | 68 |
| 2021 July | 28 | 8 | 36 |
| 2021 June | 30 | 6 | 36 |
| 2021 May | 41 | 8 | 49 |
| 2021 April | 43 | 13 | 56 |
| 2021 March | 30 | 12 | 42 |
| 2021 February | 15 | 10 | 25 |
| 2021 January | 19 | 11 | 30 |
| 2020 December | 15 | 12 | 27 |
| 2020 November | 14 | 9 | 23 |
| 2020 October | 13 | 8 | 21 |
| 2020 September | 15 | 10 | 25 |
| 2020 August | 9 | 4 | 13 |
| 2020 July | 16 | 2 | 18 |
| 2020 June | 17 | 13 | 30 |
| 2020 May | 11 | 5 | 16 |
| 2020 April | 7 | 5 | 12 |
| 2020 March | 14 | 5 | 19 |
| 2019 February | 1 | 0 | 1 |
| 2018 July | 0 | 0 | 0 |
| 2018 June | 1 | 0 | 1 |
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