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A 45-year-old woman presented to the gastrointestinal surgical department with a 2-month
history of enlarging abdominal mass. Physical examination revealed an abdominal tumor
of approximately 30.0 cm in diameter. Endoscopic ultrasonography showed an extraluminal
growing tumor arising from the muscular layer of the gastric wall. Abdominal contrast-enhanced
CT revealed a giant cystic-solid tumor originated from the big curved side of gastric
corpus, which was considered as a plexiform fibromyxoma of the stomach (Fig. 1A and B). An exploratory laparotomy was performed and the tumor was confirmed originated
from the stomach and it was rich in mucus (Fig. 2A). The tumor was completely removed with partial gastrectomy and postoperative pathological
examination revealed gastric myxoid epithelioid tumor (Fig. 2B and C). Immunohistochemistry showed that CD117, CD34 and Dog-1 were positive, but
CK and Melan-A were negative, which was consistent with the diagnosis of gastrointestinal
stromal tumor. Gene detection revealed the C-kit gene was wild-type but the exon 18
of PDGFR-α gene was mutant-type (D842V). The patient recovered well after surgery
and is undergoing the treatment of avapritinib.
Fig. 1Abdominal contrast-enhanced CT revealed a giant cystic-solid tumor originated from
the big curved side of gastric corpus.
Author Contributions: All authors cared for the patient. ZL, YZ and YL did the operation. ZL and YJ acquired the figures. ZL devised the original idea for the report and drafted the original manuscript. All authors critically reviewed the article.
Patient consent and ethics committee approval: Written consent for publication was obtained from the patient. Also, our study and manuscript were obtained ethics committee approval.
