Robot-assisted partial gastrectomy with Billroth I anastomosis for gastric plexiform fibromyxoma in children: the first case report and literature review.

Background: Plexiform fibromyxoma (PF) is an extremely rare mesenchymal tumor, which was first reported by Takahashi et al. in 2007 and named by the World Health Organization (WHO) in 2010 in the classification of digestive system tumors. Currently, only 123 cases have been reported globally, and complete surgical resection is the only effective treatment. On October 20, 2023, we successfully performed a robot-assisted partial gastrectomy with Billroth I anastomosis to remove gastric PF. Since the operation, the child has recovered well. After literature search and novelty confirmation, it was confirmed to be the first case globally (novelty confirmation number: 44011120230247C). Based on this, we reviewed relevant literature and summarized the surgical experience of this case.

Case description: A 7-year-old Chinese female patient was admitted to Guangzhou Women and Children's Medical Center in October 2023. Due to "pallor for 4 months and the discovery of a tumor in the gastric antrum over 2 weeks ago", an enhancement CT scan revealed a mass in her gastric antrum, approximately 4.0 cm × 3.5 cm × 3.0 cm in size, but its nature remains to be determined. On electronic gastroscopy, a mass was identified in the gastric antrum and pylorus orifice. It exhibited a smooth surface, with its base located on the lesser curvature side and pylorus. We did robot-assisted partial gastrectomy with Billroth I anastomosis for her to remove the mass. Now it has been 11 months after the operation, and the child has recovered well with no sign of mass recurrence.

Conclusions: This study confirms that the robot-assisted partial gastrectomy with Billroth I anastomosis for the treatment of gastric PF in children is safe and feasible, and there are no complications of the operation.