Fibrous tumor of the stomach causing abdominal pain and melena: Case report with review of literature

INTRODUCTION

Fibrous tumor of the stomach is a rare mesenchymal tumor composed of hyalinized fibrous tissue with spindle shaped fibroblasts. This type of tumor usually occurs in the subcutaneous tissues and the deep soft tissues. Its occurrence in stomach is extremely a rare finding and only few cases have been reported worldwide, the exact etiology is still unclear.

PRESENTATION OF CASE

A 68-year-old female was complaining from epigastric and right hypochondrial pain for few months. It was associated with attacks of non-bilious vomiting and early satiety, with attacks of melena. During abdominal examination there was a palpable mass in the epigastric region which was oval in shape, soft, mobile in the vertical direction, and was non-pulsatile. The hemoglobin was 9 gm/liter. Ultrasound and CT-scan of the abdomen showed a well-defined non-enhancing, multi-loculated mass related to the body of the stomach. Gastroscopy showed soft tissue mass with intact mucosa in the anterior gastric wall, multiple biopsies were taken which revealed fatty tissue with no evidence of malignancy. Laparotomy was done and a soft, mobile mass was found in the anterior gastric wall in the pre-pyloric region, the serosa was intact, complete excision of the mass was performed. The histopathological result showed fibrous tumors of the stomach.

CONCLUSION

The treatment of this tumor is mainly through surgical intervention. Which should be done at the time of diagnosis. The prognosis after successful resection is excellent, few cases are reported with local recurrence.

Infantile digital fibromatosis (inclusion body fibromatosis) observed in a baby without finger involvement

A 9-day-old male baby was hospitalized after his birth due to some swells under the skin. The hard consistency nodules observed under the skin all over the body of the patient were of different size, and presented lesions, among which the biggest was 1 × 1 cm. No lesions were observed on the fingers. By superficial ultrasonography, multiple isoechoic hypoechoic lesions were observed among the muscle plan. In thoracolumbar magnetic resonance imaging, multiple massif lesions retaining peripheral contrast (the biggest was 1.7 × 1.4 cm large) had been observed under the skin muscle plans, between the muscles of the extremities. The biopsy was positive for smooth muscle actin, but negative for desmin, S100, and CD34. These findings were diagnosed as infantile digital fibromatosis (IDF) (inclusion body fibromatosis). The case was presented with an objective to illustrate and remind that IDF can be observed in babies without finger involvement.