PMC7154269_01
Preoperative imaging inspection findings. a The shadow defect with bridging fold, about 40 mm in diameter, was pointed in the middle of the gastric body in the upper gastrointestinal X-ray. b Upper endoscopy revealed an elevated submucosal mass, about 40 mm in diameter, in the gastric body at the greater curvature. c A contrast-enhanced CT in the axial section showed the tumor measuring 52 mm in the stomach. d A contrast-enhanced CT in the coronal section showed the tumor with extramural growth in the stomach.
cro-0013-0330-g01.jpg
PMC7154269_01_cro-0013-0330-g01.jpg
F1
She visited our hospital due to an abnormal upper gastrointestinal X-ray at the medical checkup (Fig. 1a). An upper endoscopy revealed an elevated submucosal gastric mass on the greater curvature, and a normal overlying mucosa without ulceration (Fig. 1b). A contrast-enhanced computed tomography (CT) showed the tumor measuring 52 mm on the axial section (Fig. 1c), with extramural growth on the coronal section in the stomach (Fig. 1d).
Intraoperative findings. a The great omentum was dissected by laparoscopic surgery to expose the tumor. The tumor was then pulled just below the port of the laparoscope. b The part of the stomach with the tumor was removed from the body. Wedge gastrectomy was performed.
cro-0013-0330-g02.jpg
PMC7154269_01_cro-0013-0330-g02.jpg
F2
Laparoscopic-assisted wedge gastrectomy was performed and a complete resection with negative surgical margin (R0) was obtained (Fig. 2a, b).
The results of HE staining and immunostaining. a The tumor shows the lesion, composed of spindle cells with nuclei, arranged in a palisade. b There is lymphocytic cuffing at the peripheral part of the tumor. c The tumor cells are positive for S-100 protein. d The tumor cells are negative for CD34. e The tumor cells are negative for the c-kit. f The MIB-1 labeling index is 5%.
cro-0013-0330-g03.jpg
PMC7154269_01_cro-0013-0330-g03.jpg
F3
Pathological examination with hematoxylin and eosin staining of the specimen revealed a solid tumor which was highly cellular and consisted of spindle cells (Fig. 3a), surrounded by a peripheral lymphoid cuff (Fig. 3b). Immunohistochemistry revealed that the tumor cell was strongly positive for S-100 protein (Fig. 3c) and negative for CD34 and c-kit (Fig. 3d, e). In addition, the MIB-1 max labeling index was 5% (Fig. 3f).