Gastric calcifying fibrous tumor suspected to be complicated with immunoglobulin G4-related disease treated by laparoscopy and endoscopy cooperative surgery: a case report

• Published in: Surgical case reports 2019-10, Vol.5 (1), p.1-4, Article 150
• Main Authors: Hamura, Ryoga, Koyama, Tomoki, Kawamura, Masahiko, Kawamura, Takeshi, Nakamura, Mayo, Yanaga, Katsuhiko
• Format: Article
• Language: English
• Subjects: Autoimmune diseases; Calcification; Calcifying fibrous tumor; Case Report; Case reports; Endoscopy; Gastric cancer; Gastrointestinal cancer; IgG4-related disease; Immunoglobulins; Laparoscopy; LECS; Medicine; Medicine & Public Health; Surgery
• ISSN: 2198-7793; 2198-7793
• DOI: 10.1186/s40792-019-0714-6

Background Calcifying fibrous tumor (CFT) is a rare benign soft tissue lesion. Case presentation A 30-year-old woman was admitted to our hospital with complaints of epigastralgia. A 15-mm submucosal tumor was identified in the greater curvature of the superior body of the stomach by upper gastrointestinal endoscopy. Endoscopic ultrasonography revealed a hypoechoic lesion with an acoustic shadow consistent with calcification. Computed tomography showed a gastric tumor with calcification. A gastrointestinal stromal tumor was diagnosed, and gastric wedge resection was performed by laparoscopy and endoscopy cooperative surgery. On pathological examination, the tumor was identified to be a CFT. Postoperative serum IgG4 levels were 26.0 mg/dl, which supported the diagnosis of probable immunoglobulin G (IgG) 4-related disease, according to the comprehensive diagnostic criteria of IgG4-related disease. The patient was discharged on postoperative day 7 and remains well with no evidence of tumor recurrence for 2 years after resection. Conclusion We herein reported a patient with a gastric CFT suspected to be complicated with immunoglobulin G4-related disease that was successfully treated by laparoscopy and endoscopy cooperative surgery.