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      Gastric Adenomyosis: A Rare Cause of Pyloric Mass in Children

      case-report

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          Abstract

          Adenomyoma of the stomach is a benign tumor with a very low incidence. Clinical presentation and imaging modalities are usually nonspecific and variable. A rare case of gastric adenomyoma in a 12-year-old child is being reported who presented with gastric outlet obstruction. The diagnosis could only be established after an excision biopsy performed after multiple diagnostic modalities failed to clinch the diagnosis. The case is being reported in view of the rarity of this entity in the pediatric age group as a cause of gastric outlet obstruction.

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          Adenomyoma of the stomach.

          R A Lasser, W Koufman (1977)
          Two cases of adenomyoma of the stomach and a review of previous reports in the literature are presented. Adenomyoma is a benign lesion of the pylorus of the stomach composed of smooth muscle, cysts, and glandular structures lined by all columnar epithelium, Brunner's glands, and sometimes pancreatic tissue. The histopathological and radiological characteristics of this lesion are discussed.
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            Gastric Adenomyoma: The Unexpected Mimicker

            Marcela Adriana Duran Alvarez, Juan Ramón Gómez López, Teresa Guerra Garijo (2017)
            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.
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              Atypical presentation of myoepithelial hamartoma in the antrum of the stomach, mimicking a gastrointestinal stromal tumor: a case report

              Junaid Nabi, Fatema N. Authoy, Sarker Mohammad Quamrul Akhter (2012)
              Introduction A myoepithelial hamartoma is a very uncommon submucosal tumor of the stomach. In an atypical presentation in our case, it mimicked the clinical presentation of a gastrointestinal stromal tumor. To the best of our knowledge, it is the first case of a hamartoma of the stomach reported from Bangladesh and one of few cases described in the literature. Case presentation We describe the case of a 35-year-old Bengali man with recurrent epigastric pain and occasional vomiting with radiographic findings of a gut mass. An upper gastrointestinal endoscopy revealed a healed duodenal ulcer, deformed ‘D’ bulb and a submucosal swelling in his antrum. Ultrasonography and a contrast-enhanced computed tomography scan confirmed the presence of a well-defined, oval gut mass in his upper abdomen, compressing his duodenum. The mass had a mixed density and was considered to probably be a gastrointestinal stromal tumor. Ultrasonography-guided fine needle aspiration cytology was inconclusive. After resection at laparotomy, a histopathological examination revealed a myoepithelial hamartoma. These tumors are characterized by hypertrophic smooth muscle bands surrounding varied epithelial elements, which may be arranged in diverse patterns such as simple glandular structure, Brunner’s gland, pancreatic ducts and sometimes pancreatic acini. This case report is complemented by a literature review relating to the atypical presentation. Conclusion Gut masses need to be investigated thoroughly and the possibility of rare tumors should not be excluded. Although the recommended treatment for such lesions is limited resection, radical procedures such as a pancreaticoduodenectomy are often performed when the lesion occurs in the periampullary area because of preoperative misdiagnosis as a carcinoma. Therefore, it is essential for clinicians to maintain current knowledge of the lesion to avoid inaccurate diagnosis and prevent unnecessary surgery.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Indian Assoc Pediatr Surg
                Journal ID (iso-abbrev): J Indian Assoc Pediatr Surg
                Journal ID (publisher-id): JIAPS
                Title: Journal of Indian Association of Pediatric Surgeons
                Publisher: Wolters Kluwer - Medknow (India )
                ISSN (Print): 0971-9261
                ISSN (Electronic): 1998-3891
                Publication date (Print): May-Jun 2020
                Publication date (Electronic): 11 April 2020
                Volume: 25
                Issue: 3
                Pages: 172-174
                Affiliations
                [1]Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, India
                [1 ]Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
                [2 ]Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
                Author notes
                Address for correspondence: Dr. Anjan Kumar Dhua, Room No 4002, Department of Paediatric Surgery, Teaching Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. E-mail: anjandhua@ 123456hotmail.com
                Article
                Publisher ID: JIAPS-25-172
                DOI: 10.4103/jiaps.JIAPS_44_19
                PMC ID: 7302453
                SO-VID: 75645c1d-e766-48f9-8ca7-bdeb5e5d81f2
                Copyright © Copyright: © 2020 Journal of Indian Association of Pediatric Surgeons
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Date received : 03 March 2019
                Date revision received : 05 March 2019
                Date accepted : 25 May 2019
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Keywords: adenomyoma,gastric outlet obstruction,myoepithelial hamartoma
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: adenomyoma, gastric outlet obstruction, myoepithelial hamartoma

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