doiSerbia

Gastric adenomyoma

Kerkez Mirko D. (School of Medicine, Clinical Center of Serbia, Clinic of Surgery, Belgrade)
Lekić Nebojša S. (School of Medicine, Clinical Center of Serbia, Clinic of Surgery, Belgrade)
Ćulafić Đorđe M. (School of Medicine, Clinical Center of Serbia, Clinic of Gastroenterology and Hepatology, Belgrade)
Ražnatović Zoran J. (School of Medicine, Clinical Center of Serbia, Clinic of Surgery, Belgrade)
Ignjatović Igor I. (School of Medicine, Clinical Center of Serbia, Clinic of Surgery, Belgrade)
Lekić Dragana D. (Institute for Mother and Children Health Care, Belgrade)
Mijač Dragana D. (School of Medicine, Clinical Center of Serbia, Clinic of Gastroenterology and Hepatology, Belgrade)

Bacground. Gastric adenomyoma is a rare, hamartomatous tumor localized most frequently in the gastric antrum. Review of the available literature shows only sporadic reports or smaller series. Case reports. We presented a 72-year-old woman admitted due to epigastric pain with dyspeptic difficulties. Biochemical parameters and tumor markers were within the referential limits. Diagnostic procedures (upper endoscopy, endoscopic ultrasonography and computerized tomography) revealed an intramural tumor prominence with intact mucosa on the posterior wall of gastric antrum, not accessible for biopsy. Surgical treatment was performed with total extirpation of the tumor. Histopathological examination verified adenomyoma with focal low grade epithelial dysplasia. Cytologic immunophenotype was consistent with smooth muscle stromal and epithelial tumor (CK7 and CK20 ++ immunophenotype). Stromal component revealed low proliferative index (Ki-67 protein immunoexpression level 3%), and p53 less than 0.1% in both epithelial and stromal components. Following the operation, the patient remained in good condition. Conclusion. Uncertain malignant potential of the gastric adenomyoma in the presented case indicates that timely diagnostics with adequate surgical treatment is crucial for an adequate treatment.

Keywords: adenomyoma, stomach neoplasms, diagnosis, treatment outcome