Case Report
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World J Gastrointest Endosc. Sep 16, 2013; 5(9): 457-460
Published online Sep 16, 2013. doi: 10.4253/wjge.v5.i9.457
Gastric calcifying fibrous tumor removed by endoscopic submucosal dissection
Naotaka Ogasawara, Shinya Izawa, Mari Mizuno, Atsushi Tanabe, Tomonori Ozeki, Hisatsugu Noda, Emiko Takahashi, Makoto Sasaki, Toyoharu Yokoi, Kunio Kasugai
Naotaka Ogasawara, Shinya Izawa, Mari Mizuno, Atsushi Tanabe, Tomonori Ozeki, Hisatsugu Noda, Makoto Sasaki, Kunio Kasugai, Department of Gastroenterology, Aichi Medical University School of Medicine, Aichi 480-1195, Japan
Emiko Takahashi, Toyoharu Yokoi, Department of Pathology, Aichi Medical University School of Medicine, Aichi 480-1195, Japan
Author contributions: Ogasawara N, Izawa S and Tanabe A performed endoscopic submucosal resection of the submucosal tumor; Mizuno M, Ozeki T and Noda H managed the patient’s condition during hospitalization; Takahashi E and Yokoi T pathologically diagnosed the SMT as a gastric calcifying fibrous tumor; Ogasawara N, Sasaki M and Kasugai K wrote the manuscript.
Correspondence to: Naotaka Ogasawara, MD, Department of Gastroenterology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan. nogasa@aichi-med-u.ac.jp
Telephone: +81-561-623311 Fax: +81-561-621508
Received: June 9, 2013
Revised: July 1, 2013
Accepted: August 4, 2013
Published online: September 16, 2013
Processing time: 128 Days and 20.9 Hours
Abstract

The World Health Organization describes calcifying fibrous tumors (CFTs) as rare, benign lesions characterized by hypocellular, densely hyalinized collagenization with lymphoplasmacytic infiltration. These tumors rarely involve the gastrointestinal (GI) tract. A routine endoscopic upper gastrointestinal screen detected a 10-mm submucosal tumor (SMT) in the lesser curvature of the lower corpus of the stomach of an apparently healthy, 37-year-old woman with no history of Helicobacter pylori infection. Endoscopic ultrasonography (EUS) localized the internally isoechoic, homogeneous SMT mainly within the submucosa. Malignancy was ruled out using endoscopic submucosal dissection (ESD). A pathological examination confirmed complete resection of the SMT, and defined a hypocellular, spindle-cell tumor with a densely hyalinized, collagenous matrix, scattered lymphoplasmacytic aggregates as well as a few psammomatous, dystrophic calcified foci. The mass was immunohistochemically positive for vimentin and negative for CD117 (c-kit protein), CD34, desmin, smooth muscle actin (SMA) and S100. Therefore, the histological findings were characteristic of a CFT. To date, CFT resection by ESD has not been described. This is the first case report of a gastric calcifying fibrous tumor being completely resected by ESD after endoscopic ultrasonography.

Keywords: Calcifying fibrous tumor; Endoscopic submucosal dissection; Submucosal tumor; Endoscopic ultrasonography

Core tip: Calcifying fibrous tumors (CFTs) rarely involve the gastrointestinal tract. Resection of CFT by endoscopic submucosal dissection (ESD) has not been reported. This is the first case report of a gastric calcifying fibrous tumor being completely resected by ESD after endoscopic ultrasonography.