J Korean Surg Soc.  2012 Jul;83(1):56-59. 10.4174/jkss.2012.83.1.56.

Calcifying fibrous tumor of the stomach: a case report

• Jang KY
• Park HS
• Moon WS
• Lee H
• Kim CY

• KMID: 2212280
• DOI: http://doi.org/10.4174/jkss.2012.83.1.56

Abstract

Calcifying fibrous tumor (CFT) is a rare, benign mesenchymal tumor usually affecting children and young adults, and it shows a predilection for the soft tissue and the abdominal cavity. Intrinsic visceral CFT is extremely rare and we present herein the case of a 59-year-old man with an asymptomatic gastric lesion, incidentally detected 1 month before this presentation. Thus, gastric endoscopy revealed a polypoid submucosal mass in the fundus, covered by an erythematous mucosa. The polypoid mass was a 3.9 x 2.7 cm-sized well-defined tumor located in the proper muscle, with extension to the subserosa. The tumor showed characteristic hypocellular sclerosis with coarse collagen, mononuclear inflammatory infiltrates, sparse fibroblastic spindle cells and occasional, psammomatous or dystrophic calcifications. Immunohistochemically, the spindle cells were negative for CD117, CD34, platelet-derived growth factor receptor-alpha, S100, smooth muscle actin, desmin and anaplastic lymphoma kinase.

Keyword

Stomach; Gastrointestinal stromal tumors; Calcifying fibrous tumor

MeSH Terms

Abdominal Cavity
Actins
Child
Collagen
Desmin
Endoscopy
Fibroblasts
Gastrointestinal Stromal Tumors
Humans
Lymphoma
Middle Aged
Mucous Membrane
Muscle, Smooth
Muscles
Phosphotransferases
Platelet-Derived Growth Factor
Receptor Protein-Tyrosine Kinases
Sclerosis
Stomach
Young Adult
Actins
Collagen
Desmin
Phosphotransferases
Platelet-Derived Growth Factor
Receptor Protein-Tyrosine Kinases

Figure

• 

  Fig. 1 (A) Endoscopic evaluation reveals the polypoid submucosal mass in the greater curvature of the gastric fundus with mild erythematous mucosa. (B) Contrast-enhanced computed tomography scan reveals the well-circumscribed, non-enhanced, homogeneous, round mass at the great curvature of the gastric fundus.

• 

  Fig. 2 (A) Cut-section reveals the well-defined tumor measuring 3.9 × 2.7 cm covered by intact mucosa. The tumor is located in the proper muscle with extension to the subserosa and shows a homogeneous yellow to white, firm surface. (B) The tumor is well-circumscribed, but not encapsulated, and located in the proper muscle (H&E, ×20). (C) The tumor shows characteristic hypocellular sclerosis, with wavy collagen and scattered mononuclear inflammatory infiltrates (H&E, ×100). Note the sparse spindle cells dispersed among thick collagen bundles and some plasma cells (inset, H&E, ×400). (D) Occasional psammomatous and dystrophic calcifications are found (H&E, ×100). (E) Spindle cells show no immunoreactivity for CD117 (CD117, ×100). Note the immunoreactive mast cells, as the internal positive control (inset, CD117, ×400). (F) Spindle cells show no immunoreactivity for smooth muscle actin (SMA, ×200). Note the immunoreactive vascular walls, as the internal positive control.

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