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Case Reports
. 2017 Jul;24(4):198-202.
doi: 10.1159/000453302. Epub 2017 Jan 5.

Gastric Adenomyoma: The Unexpected Mimicker

Marcela Adriana Duran Álvarez  1 , Juan Ramón Gómez López  2 , Teresa Guerra Garijo  3
Affiliations
Case Reports

Gastric Adenomyoma: The Unexpected Mimicker

Marcela Adriana Duran Álvarez et al. GE Port J Gastroenterol. 2017 Jul.

Abstract
in English, Portuguese

Gastric adenomyoma is a rare benign tumor composed of epithelial structures and smooth muscle stroma. Here, we report an unusual case of gastric adenomyoma mostly composed of smooth muscle that was incidentally found during a laparoscopic intervention. On radiology, it mimicked an acquired hypertrophic pyloric stenosis in an adult patient, and pathologically it resembled a pure smooth muscle hamartoma. Complete submission of the lesion for histology was necessary to find the epithelial component and make the right diagnosis. As a mimicker of benign and malignant entities, gastric adenomyoma is usually an unexpected finding after surgery. The aim of this report is to analyze this adenomyoma variant in the setting of an unexplained thickening of the gastric wall, with explanations concerning histogenesis and biological potential.

O Adenomioma gástrico é um tumor benigno raro composto por estruturas epiteliais e por um estroma muscular liso. Aqui apresenta-se um caso invulgar composto maioritariamente por músculo liso, que foi identificado acidentalmente no decurso de uma intervenção laparoscópica. Na imagiologia a lesão simulava uma estenose pilórica hipertrófica adquirida do adulto e na anatomia patológica assemelhava-se a um hamartoma de músculo liso puro. A inclusão total da lesão para análise histológica permitiu encontrar o componente epitelial e o diagnóstico correto. Sendo um imitador de doenças benignas e malignas, o adenomioma gástrico é habitualmente um achado inesperado após a cirurgia. O objetivo da apresentação deste caso é reconhecer esta variante de adenomioma no contexto de um espessamento inexplicável da parede gástrica, com comentários sobre a sua histogénese e potencial biológico.

Keywords: Adenomyoma; Hamartoma; Pancreas/abnormalities; Pyloric stenosis; Stomach neoplasms.

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Figures

Fig. 1
Fig. 1
CT scan of the abdomen showing a normal pancreatic head (yellow arrowhead) and a thickened gastric wall (red arrow).
Fig. 2
Fig. 2
A thickened gastric wall and submucosal lipomatosis are shown.
Fig. 3
Fig. 3
Whole amount of epithelial component on slides, showing dilated spaces in the gastric wall.
Fig. 4
Fig. 4
Islands of epithelial ducts and glands surrounded by smooth muscle bundles. HE. 20×.
Fig. 5
Fig. 5
Patchy expression of CA 19.9 in small ducts of epithelial islands. HE. 20×.
Fig. 6
Fig. 6
CK 7 expression in epithelial lining of dilated ducts. HE. 20×.
See this image and copyright information in PMC

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