Abstract
BackgroundPlexiform angiomyxoid myofibroblastic tumor (PAMT) is a very rare mesenchymal tumor of the stomach. Here we report a case of pathologically confirmed PAMT with an unique cyst formation.Case presentationA 55-year-old male with a 10-year history of a gastric subepithelial tumor underwent computed tomography (CT) and magnetic resonance imaging (MRI). Two cysts were observed in the tumor, and the cyst wall showed moderately high intensity on T2-weighted images compared with the gastric wall. On dynamic study, the cyst wall showed a gradual enhancement pattern, and prominent enhancement was observed in the delayed phase. Laparoscopic partial gastric resection was performed, and a pathological diagnosis of PAMT was rendered.ConclusionWe present a rare case of gastric PAMT, which was uniquely presented as cysts. One of the cysts in the tumor had an epithelial wall lining, which had never been reported before in gastric mesenchymal tumor, in addition to partial glandular structure. We reviewed our case, focusing on radiologic-pathologic correlation, and suggested hypothesis of cyst formation. According to our findings, PAMT with cyst formation would be included of differential diagnosis of gastric subepithelial tumors.
Highlights
Plexiform angiomyxoid myofibroblastic tumor (PAMT) is a very rare mesenchymal tumor of the stomach
PAMT with cyst formation would be included of differential diagnosis of gastric subepithelial tumors
The incidence of PAMT is estimated to be less than 1 in 150 compared with gastric gastrointestinal stromal tumor (GIST) [2], and only 34 cases of PAMT have been reported in the English language literature, with scant data pertaining to computed tomography (CT) and magnetic resonance imaging (MRI) findings [3–19]
Summary
We reported a case of PAMT, a rare subepithelial mesenchymal tumor of the stomach. MRI and dynamic study findings reflected the myxoid nature of this tumor well. A cyst with an epithelial wall lining was observed in the gastric subepithelial mesenchymal tumor for the first time. We believe radiologist should be aware that PAMT should be included to differential diagnosis of cystic subepithelial tumor with myxoid imaging feature. 1.7 angle low case iso NA indicates that data was not available, EC indicates that only enhanced, CT was performed and parenthesis shows description in original case reports, PE represents gradual enhancement pattern plus prominent enhancement in delayed phase For T1WI, T2WI and DWI, tumor signal is compared to that of the gastric wall
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