J Korean Soc Radiol.  2014 Jan;70(1):47-52. 10.3348/jksr.2014.70.1.47.

Plexiform Angiomyxoid Myofibroblastic Tumor of the Stomach: Report of a Case and Review of the Literature

• Baek SH
• Yoon JH
• Kim JY

• KMID: 1897260
• DOI: http://doi.org/10.3348/jksr.2014.70.1.47

Abstract

We report a case of a plexiform angiomyxoid myofibroblastic tumor of the stomach that developed in a 38-year-old woman who underwent gastrofiberscopy and multi-detector computed tomography scans due to dyspepsia for 3 months. There was a subepithelial protruding mass with a small central mucosal ulceration and heterogeneous prominent enhancement in the gastric upper body along the greater curvature. The tumor measured 3.5 x 2.3 cm in size and showed a multinodular plexiform growth pattern of bland spindle cells in the myxoid stroma with abundant small blood vessels. The tumor cells were negative for CD117 (c-KIT), CD34, and S-100 protein but diffusely positive for smooth muscle actin and Alcian blue. The pathologic examination demonstrated that the lesion was a plexiform angiomyxoid myofibroblastic tumor. The patient is doing well and has had no recurrence or metastasis for 6 months after the wedge resection.

MeSH Terms

Actins
Adult
Alcian Blue
Blood Vessels
Dyspepsia
Female
Gastrointestinal Stromal Tumors
Humans
Muscle, Smooth
Myofibroblasts*
Neoplasm Metastasis
Recurrence
S100 Proteins
Stomach*
Ulcer
Actins
Alcian Blue
S100 Proteins

Figure

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  Fig. 1 A 38-year-old woman with an incidentally detected subepithelial tumor of the stomach. A-C. MDCT scan axial image at the late arterial phase (A), delayed phase (B), sagittal-reconstructed scan (C) demonstrating a 3 × 2 cm-sized sessile polypoid mass with prominent contrast enhancement in the high body along the greater curvature. The enhancement pattern is heterogeneous, with some portions demonstrating a highly vascular enhancement and some portions showing a lesser degree of enhancement. D. Upon endoscopy, a 3 × 2 cm-sized luminal protruding polypoid subepithelial tumor lesion with central mucosal ulceration is found at the upper body, posterior wall and greater curvature side of the stomach. Note.-MDCT = multi-detector computed tomography

• 

  Fig. 2 A 38-year-old woman performed wedge resection for an incidentally detected subepithelial tumor of the stomach. A. Upon histopathology (Hematoxylin and Eosin, × 100), the tumor is characterized by multinodular plexiform growth pattern. B. The tumor is composed of bland-looking spindle cells scattered in the myxoid stroma rich in small vessels (Hematoxylin and Eosin, × 400). C. Immunohistochemically, the tumor cells are positive for smooth muscle actin (× 400). D. The myxoid stroma is positive under alcian blue staining (× 400).

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