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Published on: January 31, 2016
An Unusual Stomach Tumour: Plexiform Angiomyxoid Fibroma Stomach-A Case Report
Sharath K Krishnan1, Ravindran Chirukandath1, Togy Zachariah2
1Department of General Surgery, Government Medical College, Thrissur, 680596 Kerala India.
Abstract:
Plexiform angiomyxoid myofibroblast tumour (PAMT) is a rare mesenchymal tumour of the stomach. To date, about 45 cases of PAMT have been reported in the literature. This is an extremely rare mesenchymal gastric tumour with definite histological pattern and is a tumour typified by spindle cells with myofibroblast characteristics. A 70-year-old woman was admitted with vague upper abdominal pain and dyspepsia and on OGD was found to have a polypoidal lesion with ulceration on the posterior wall of the body of the stomach towards the greater curvature. The endoscopy biopsy suggested the above diagnosis. The patient was investigated with CT scan and CT showed a large nodular growth 10 × 8 cm with pancreatic tail involvement and splenic involvement. The patient was treated with multi-visceral resection and favourable outcome was achieved. This entity of PAMT was a histological rarity and a technically challenging case and hence was analysed and presented. PAMT is a rare mesenchymal tumour of the stomach and is characterised by spindle cells with myofibroblast characteristics with a potential to differentiate towards smooth muscle cells. These tumours have a benign course and rarely can have an infiltrative behaviour. PAMT of the stomach is a very rare mesenchymal tumour with a unique histological appearance, and it needs to be distinguished from GIST and other gastrointestinal mesenchymal tumours, although extra gastric extension and vascular invasion are sometimes observed. Here, we are reporting this case as a case of PAMT arising from the body of the stomach which required multi-visceral resection.
Insights
Plexiform angiomyxoid myofibroblast tumour (PAMT) is a rare gastric mesenchymal tumor. This case highlights a large PAMT requiring multi-visceral resection, emphasizing its rarity and challenging surgical management.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Plexiform angiomyxoid myofibroblast tumour (PAMT) is an exceptionally rare mesenchymal neoplasm of the stomach.
- Fewer than 50 cases have been documented, characterized by spindle cells with myofibroblast features.
Purpose of the Study:
- To report a rare case of PAMT in the gastric body.
- To discuss the diagnostic and surgical challenges posed by this rare entity.
Main Methods:
- Case presentation of a 70-year-old woman with upper abdominal pain and dyspepsia.
- Diagnostic workup included esophagogastroduodenoscopy (OGD) and CT scan.
- Surgical management involved multi-visceral resection.
Main Results:
- OGD revealed a polypoidal lesion with ulceration; biopsy suggested PAMT.
- CT scan demonstrated a large tumor (10x8 cm) with pancreatic and splenic involvement.
- Multi-visceral resection resulted in a favorable outcome.
Conclusions:
- PAMT is a rare gastric mesenchymal tumor with a unique histology, distinct from GIST.
- While typically benign, PAMT can exhibit infiltrative behavior and require extensive surgical intervention.
- This case underscores the importance of recognizing PAMT and the technical complexities of its surgical resection.
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