Laparoscopic partial gastrectomy for gastric calcifying fibrous tumor: a case report and literature review

Introduction: Calcifying fibrous tumor (CFT) is a rare benign lesion that occasionally arises in the gastrointestinal tract. Gastric CFT is extremely uncommon and often mimics gastrointestinal stromal tumor (GIST), making preoperative diagnosis challenging. Presentation of Case: We report a 46-year-old man with a gastric submucosal tumor detected during a medical checkup. During 3 years of follow-up, the tumor increased in size from 20 mm to 30 mm. Endoscopic ultrasonography revealed a hyperechoic lesion located medial to the muscularis propria, and abdominal computed tomography showed a calcified submucosal mass with contrast enhancement. Fine-needle aspiration biopsy failed to provide a definitive diagnosis, and malignant potential, including GIST, could not be excluded. Therefore, laparoscopic partial gastrectomy was performed. Histopathological examination revealed dense collagen, psammomatous calcification, spindle cells, and lymphoplasmacytic infiltrates, consistent with CFT. The final pathological tumor size was 15 mm. Immunohistochemistry showed positivity for vimentin and negativity for c-kit, DOG1, SMA, and CD34. The postoperative course was uneventful, and there has been no recurrence observed during 2.5 years of follow-up. Discussion: Gastric CFT is rare, with only 22 cases reported worldwide since 2014. Most cases of gastric CFT were managed by endoscopic resection, while laparoscopic surgery has rarely been reported. Radiologic and endoscopic findings may help differentiate CFT from GIST, but definitive diagnosis requires histopathology. Conclusion: Laparoscopic resection is a safe and effective treatment option when gastric CFT cannot be preoperatively distinguished from GIST. Awareness of this rare entity may prevent overtreatment and guide optimal surgical decision-making.