Abstract
Introduction: Solitary fibrous tumors (SFTs) are rare spindle cell tumors that usually arise from the pleura. In a few case reports, they have been found in other sites. We present a rare case of gastric SFT presenting with bloody emesis. A 50-year-old female presented with coffee ground emesis associated with melena for 6 days. Physical examination was significant for pallor and tachycardia. Abdominal examination was benign. Laboratory results revealed iron deficiency anemia with a hemoglobin of 1.8 but otherwise unremarkable. EGD showed a 4-5 cm bilobed mass near the junction of the stomach antrum and body. Biopsy was inconclusive. Radiographic staging confirmed gastric mass without evidence of metastasis. Laparotomy with wedge resection of the stomach showed a 5.0 x 3.8 x 3.1 cm, exophytic mass with central ulceration. Pathology showed gastric wall containing spindle cell tumor ulcerating through the mucosa. Histologic and immunohistochemistry picture (diffuse CD34 and bcl2 positivity) fit the diagnosis of angiofibromatous variant of SFT with insufficient histological criteria for malignancy. Klemperer first described SFTs in 1931. Only 15-20% are malignant. The median age of occurrence is 45 to 50 years with both sexes equally affected. Presenting symptoms depend on location and size of the tumor. Diagnosis is primarily based on histopathology which is the gold standard as clinical features and imaging play a limited role. The most effective treatment modality is complete surgical resection. To our best knowledge, we present the first case of gastric SFT of the angiofibromatous variant presenting with profound anemia.Figure 1: Gastric bi-lobed mass.Figure 2: Gross pathology of bi-lobed gastric mass.
Published Version
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