Perivascular Epithelial Cell Tumor of the Stomach Diagnosed Preoperatively by Endoscopic Ultrasound-Guided Fine-Needle Aspiration.

Introduction: Perivascular Epithelioid Cell tumor (PEComa) is a rare mesenchymal neoplasm characterized by the co-expression of melanocytic and myoid markers. While PEComas can arise in diverse anatomical sites, gastric PEComas are exceedingly rare, with merely nine cases documented in the extant literature.

Case Presentation: Herein, we have presented a case of gastric PEComa in a 65-year-old male patient who exhibited a 3-year history of epigastric pain, with notable exacerbation in the two months prior to diagnosis. For the initial evaluation of the patient's condition, Endoscopic Ultrasound-guided Fine Needle Aspiration (EUS-FNA) and Computed Tomography (CT) were employed, which enabled a preoperative diagnosis. Radiological assessment demonstrated a neoplasm exhibiting heterogeneous arterial enhancement, persistent delayed enhancement, and distinct margins. Subsequent to diagnosis, the patient underwent surgical resection and has maintained a disease-free status for one year postoperatively. This case report highlights the crucial role of EUS-FNA in facilitating preoperative histological diagnosis and optimizing surgical planning for gastric PEComa.

Conclusion: This case constitutes the tenth documented instance of gastric PEComa in the global literature. In this case, EUS-FNA facilitated a preoperative histopathological diagnosis, thereby enabling precise surgical planning. An accurate preoperative diagnosis is crucial for devising an optimal treatment strategy.