Gastric plexiform fibromyxoma resected by endoscopic submucosal dissection: A case report and review of literature

Plexiform fibromyxoma (PF), known as plexiform angiomyxoid myofibroblastic tumor firstly, is derived from gastrointestinal mesenchyme cells, being officially adopted as a distinct benign entity in the 2010 WHO Classification of Tumors of the Digestive System. We report a plexiform fibromyxoma case of a 32-year-old Chinese man who presented with slight intermittent acid regurgitation and abdominal discomfort. Endoscopy and imaging studies revealed a muscularis mucosa mass in the gastric antrum with initial suspicion of a GIST. Microscopically, spindle or oval tumor cells arrange in a nodular plexiform pattern, rich and small-sized vasculature and abundant myxoid matrix. Although it has a classical histological feature of PF, immunohistochemically it was negative for fibroblastic or myofibroblastic differentiation marker; endoscopic submucosal dissection (ESD) was performed as diagnostic therapy. Follow-up evaluation was uneventful for 8 months. To summarize the experience of conservative surgical treatment of plexiform fibromyxoma, we reviewed ESD or laparoscopic endoscopic cooperative surgery (LECS) treatment of plexiform fibromyxoma cases in the literature, and no complications and recurrence were reported after treatment. ESD is an candidate choice for plexiform fibromyxoma.