Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2018; 6(15): 1067-1072
Published online Dec 6, 2018. doi: 10.12998/wjcc.v6.i15.1067
Plexiform fibromyxoma of the small bowel: A case report
Wei-Guang Zhang, Liang-Bi Xu, Yi-Ning Xiang, Chen-Hong Duan
Wei-Guang Zhang, Liang-Bi Xu, Chen-Hong Duan, Department of Endoscopy, the Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
Yi-Ning Xiang, Department of Pathology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
Author contributions: All authors contributed to the acquisition of data, writing, and revision of this manuscript.
Informed consent statement: The patient and his family members provided written informed consent.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The guidelines of the CARE Checklist (2016) have been adopted in this report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Liang-Bi Xu, MD, Chief Doctor, Professor, Chief Physician, Department of Endoscopy, the Affiliated Hospital of Guizhou Medical University, Guiyi Street NO. 28, Guiyang 550001, Guizhou Province, China. gyzwgfd@163.com
Telephone: +86-851-86774480
Received: August 11, 2018
Peer-review started: August 14, 2018
First decision: October 5, 2018
Revised: November 5, 2018
Accepted: November 7, 2018
Article in press: November 7, 2018
Published online: December 6, 2018
Processing time: 118 Days and 2.8 Hours
Abstract
BACKGROUND

Plexiform fibromyxoma is a rare, special type of mesenchymal tumor. The most common presenting symptoms are anemia, hematemesis, and hematochezia, without sex or age predilection. The reported cases have mainly occurred in the gastric antrum and pylorus region, with some cases in the duodenum.

CASE SUMMARY

We report here a case of plexiform fibromyxoma in the upper segment of the jejunum, which was continuously followed up for 3 years after surgical removal. Plexiform fibromyxoma showed multinodular or plexiform growth. The cells in the tumor node were spindle-shaped but few in number and mitotic figures. Small blood vessels and mucous matrix were found among the tumor cells. Immunohistochemistry revealed that the plexiform fibromyxoma cells were positive for smooth muscle actin, focally positive for CD10, and negative for cytokeratin, CD117, DOG-1 (discovered on GIST-1) desmin, S-100, epithelial membrane antigen, and CD34. Ki-67 labeling index was < 5%. Plexiform fibromyxoma showed benign biological behavior. After 3 years of consecutive postoperative follow-up, no obvious signs of metastasis or recurrence were found by imaging examination.

CONCLUSION

Plexiform fibromyxoma is a rare type of mesenchymal tumor. The diagnosis mainly depends on pathological examination, and it should be distinguished from other gastrointestinal mesenchymal tumors.

Keywords: Plexiform fibromyxoma; Gastrointestinal stromal tumor; Plexiform angiomyxoid myofibroblastic tumor; Small bowel; Benign tumor; Case report

Core tip: Plexiform fibromyxoma is a rare, special type of mesenchymal tumor. It is reported to occur mainly in the gastric antrum and pylorus region, but it may also occur in the duodenum. We here report a case of plexiform fibromyxoma in the upper segment of the jejunum, which was continuously followed up for 3 years after surgical removal. No obvious signs of metastasis or recurrence were found by imaging examination.