1
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Hattori T, Tanizawa Y, Shimoda T, Koseki Y, Furukawa K, Fujiya K, Aizawa D, Sugino T, Terashima M, Bando E. Gastric inflammatory myofibroblastic tumor: a case report. Surg Case Rep 2024; 10:62. [PMID: 38485843 PMCID: PMC10940569 DOI: 10.1186/s40792-024-01844-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/13/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) of the stomach is an uncommon mesenchymal neoplasm. We present a case of gastric submucosal tumor (SMT) where the final diagnosis was IMT. CASE PRESENTATION A 69-year-old man presented with a 24-mm SMT on the posterior wall of the middle third of the stomach that was detected by screening upper gastrointestinal endoscopy. Abdominal contrast-enhanced computed tomography showed that the tumor was well-enhanced. Although endoscopic ultrasonography-guided biopsy was performed, the histological diagnosis was not confirmed preoperatively. Since the tumor was clinically suspected to be a gastrointestinal stromal tumor, we performed gastric wedge resection by laparoscopic-endoscopic cooperative surgery. Pathologically, proliferative spindle cells with a positive reaction for smooth muscle actin, negativity for c-kit, desmin, s-100, CD34, STAT-6, β-catenin and anaplastic lymphoma kinase 1 were identified. Hence, the tumor was finally diagnosed as an IMT originating from the stomach. CONCLUSIONS When an SMT of the stomach is identified, the possibility of gastric IMT should be considered.
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Affiliation(s)
- Taku Hattori
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Yutaka Tanizawa
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan.
| | - Tadakazu Shimoda
- Divisions of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Yusuke Koseki
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Kenichiro Furukawa
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Keiichi Fujiya
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Daisuke Aizawa
- Divisions of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Takashi Sugino
- Divisions of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Masanori Terashima
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Etsuro Bando
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
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Hiramatsu S, Ataka R, Nakayama Y, Hirai M, Hirata A, Takeshima J, Hirai K, Hamasu S, Aoyama I, Hirose T. Gastric inflammatory myofibroblastic tumor presented with severe anemia and inflammation: a case report. Surg Case Rep 2024; 10:5. [PMID: 38185719 PMCID: PMC10772034 DOI: 10.1186/s40792-023-01802-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/24/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) is a rare stromal tumor, often found in children and young adults, and most commonly occurs in the lungs. Surgical resection is considered the standard treatment for localized IMT, although only limited data exist. Gastric IMT in adults is extremely rare, and there are no established guidelines for its treatment. CASE PRESENTATION A 69-year-old male presented with persistent fatigue and weakness. Laboratory examination revealed severe anemia and inflammation. Upper gastrointestinal endoscopy at admission revealed a 40-mm type I softish tumor in the lesser curvature of the gastric body, without apparent hemorrhage. Repeated biopsies, including partial resection with snare, failed to give a definitive diagnosis. Computed tomography (CT) revealed a massive lesion at the gastric body, protruding into the gastric lumen, which was consistent with the gastric tumor. After admission, the patient developed anemia refractory to frequent blood transfusions despite the absence of apparent gastrointestinal bleeding. In addition, the patient had recurrent fevers of 38 °C or higher, and persistent high inflammatory levels. Fluorodeoxyglucose-positron emission tomography (FDG-PET) CT 1 month after the first visit exhibited an increased FDG uptake in the gastric tumor. In addition, this CT scan revealed a rapid increase in tumor size to 75 mm. It was suspected that the undiagnosed gastric tumor caused these serious clinical symptoms, and he underwent distal gastrectomy and cholecystectomy. The gross image of the tumor showed an 80-mm cauliflower-like shape with a gelatinous texture. The histopathological diagnosis was IMT. The postoperative course was uneventful, and the patient's symptoms subsided drastically, improving both anemia and systemic inflammation. The patient has shown no recurrence or relapse of the symptoms over one and a half years. CONCLUSIONS In this case, the tumor resection finally enabled the diagnosis of IMT and resolved the clinical symptoms. Despite its predominantly benign morphological nature, some cases of IMT present clinically adverse courses. Surgical treatment may lead to its final diagnosis and improvement of clinical symptoms.
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Affiliation(s)
- Sakura Hiramatsu
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Ryo Ataka
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan.
| | - Yusuke Nakayama
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Miho Hirai
- Department of Gastroenterology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Ayako Hirata
- Department of Gastroenterology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Jun Takeshima
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Kenjiro Hirai
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Shinya Hamasu
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Ikuo Aoyama
- Department of Gastroenterology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Tetsuro Hirose
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
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Fernandez Rodriguez M, Artuñedo Pe PJ, Callejas Diaz A, Silvestre Egea G, Grillo Marín C, Iglesias Garcia E, Lucena de La Poza JL. Gastric inflammatory myofibroblastic tumor, a rare mesenchymal neoplasm: A case report. World J Gastrointest Surg 2023; 15:2657-2662. [PMID: 38111778 PMCID: PMC10725540 DOI: 10.4240/wjgs.v15.i11.2657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/14/2023] [Accepted: 09/27/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The inflammatory myofibroblastic tumor (IMT) is a rare mesenquimal tumor of doubtful biological behaviour. It's characterised for affecting mainly children and young adults, although it can appear at any age, being the lungs the primary affected organ (in children it represents 20% of all primary pulmonary tumors). CASE SUMMARY We present the case of a 45 year old woman, with a computed tomography (CT) finding of injury on the anterior surface of the fundus/gastric body and a solid perigastric injury of 12 mm in the ecoendoscopy. The case is presented in the tumor committee deciding to perform a laparoscopic wedge resection. The histological diagnosis was a IMT. The diagnosis is based on imaging tests like the abdominal CT, abdominal ecography and the ecoendoscopy but to confirm the diagnosis a pathological study is necessary. CONCLUSION Due to the unpredictable nature of this tumor, surgical resection is the best therapeutic option.
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Affiliation(s)
- Manuel Fernandez Rodriguez
- Department of General and Digestive Surgery, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid 28222, Spain
| | - Pedro Joaquin Artuñedo Pe
- Department of General and Digestive Surgery, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid 28222, Spain
| | - Alejandro Callejas Diaz
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid 28222, Spain
| | - Gala Silvestre Egea
- Department of Pathologycal Anatomy, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid 28222, Spain
| | - Cristián Grillo Marín
- Department of General and Digestive Surgery, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid 28222, Spain
| | - Eva Iglesias Garcia
- Department of General and Digestive Surgery, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid 28222, Spain
| | - Jose Luis Lucena de La Poza
- Department of General and Digestive Surgery, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid 28222, Spain
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Kimura N, Hiraki M, Akashi M, Miyahara K, Imamura M, Furukawa S, Samejima R. A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery. Surg Case Rep 2023; 9:189. [PMID: 37902858 PMCID: PMC10616023 DOI: 10.1186/s40792-023-01767-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/14/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND An Inflammatory myofibroblastic tumor (IMT) is a rare intermediate malignancy characterized by myofibroblast proliferation and inflammatory cell infiltration. Various organs are the primary sites of origin. However, primary tumors originating in the stomach tend to be extremely rare, making the diagnosis difficult. Herein, we present a case of IMT originating in the stomach that was effectively managed using inverted laparoscopic endoscopic cooperative surgery (LECS). CASE PRESENTATION A 47-year-old male who was admitted to the hospital because of a submucosal tumor that was discovered during upper gastrointestinal endoscopy. The diameter of the tumor was approximately 20 mm. A KIT-negative gastrointestinal stromal tumor was suspected based on the biopsy findings. Therefore, partial resection of the stomach was performed using inverted laparoscopic and endoscopic cooperative surgery. Histopathological examination revealed collagen fiber proliferation from the submucosal layer to the muscular layer, accompanied by infiltration of spindle-shaped cells, lymphocytes, and numerous inflammatory cells. Immunohistochemistry results were positive for SMA and negative for CD34, desmin, and c-kit. IgG4-positive cells were observed with an IgG4/IgG ratio > 50%, and specific nuclei were positive for ALK. Therefore, IMT was diagnosed. This condition may be difficult to diagnose both before and after surgery because of its rarity and submucosal tumor-like morphology. CONCLUSION When a submucosal tumor originating in the stomach is observed, IMT should be considered. Partial resection of the stomach with LECS and immunohistochemical diagnosis may be useful.
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Affiliation(s)
- Naoya Kimura
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Masatsugu Hiraki
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan.
| | - Michiaki Akashi
- Department of Pathology, Japan Red Cross Society Karatsu Red Cross Hospital, Karatsu, Saga, Japan
| | - Koichi Miyahara
- Department of Internal Medicine, Japan Red Cross Society Karatsu Red Cross Hospital, Karatsu, Saga, Japan
| | - Minori Imamura
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Shunsuke Furukawa
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Ryuichiro Samejima
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
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5
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Hajong R, Newme K, Khongwar D. Primary inflammatory myofibroblastic tumor of stomach-report of a very rare case. J Family Med Prim Care 2021; 10:552-553. [PMID: 34017787 PMCID: PMC8132761 DOI: 10.4103/jfmpc.jfmpc_1126_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/09/2020] [Accepted: 12/01/2020] [Indexed: 11/22/2022] Open
Abstract
Primary inflammatory myofibroblastic tumor (IMT) is a very rare tumor arising from stomach and it closely mimics gastric GIST. It usually affects the lung and found in children and young patients. The diagnosis of gastric IMT is usually done post-operatively by immunohistochemistry examination where it is seen that IMT is positive to SMA and vimentin. Complete surgical excision is the treatment of choice and local recurrence is usually seen in incompletely resected cases.
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Affiliation(s)
- Ranendra Hajong
- Department of General Surgery, NEIGRIHMS, Shillong, Meghalaya, India
| | | | - Donkupar Khongwar
- Department of General Surgery, NEIGRIHMS, Shillong, Meghalaya, India
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6
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Nakanishi M, Watari J, Tomita T, Nakanishi Y, Tsukamoto Y, Matsuo S, Uchihashi T, Miyazaki J, Tanaka H, Kojima S, Kuroda N, Matsuda I, Miwa H, Shinohara H, Hirota S. Gastric CLTC-ALK fusion-positive inflammatory myofibroblastic tumor showing an endoscopic superficial depressed-type appearance. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2018.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
RATIONALE Primary gastric inflammatory myofibroblastic tumor is extremely rare. Only a few cases were reported in the domestic and foreign medical literature with corresponding imaging findings of this disease even more rarely reported. PATIENT CONCERNS We present one case of a 52-year-old female patient with upper abdominal pain, acid reflux, and belching for 2 months. DIAGNOSES AND INTERVENTIONS Electron ultrasound gastroscopy (EUS) revealed elevation of gastric antrum mucosa. A whole abdominal and pelvic multi-slice spiral computed tomography (CT) detected a round nodule in the gastric antrum with considerably delayed enhancement, with initial suspicion of gastrointestinal stromal tumors (GISTS). Then a laparoscopic assisted distal gastrectomy was performed. Finally, the postoperative pathology confirmed the diagnosis of primary gastric IMT. OUTCOMES After 6 months of follow-up, the patient was still alive without any evidence of metastasis or recurrence. LESSONS Familiarizing with the CT features of this rare tumor may raise radiologists' awareness of the disease and potentially could avoid misdiagnosis.
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Hayashi M, Kawakubo H, Mayanagi S, Nakamura R, Suda K, Wada N, Kitagawa Y. Gastric inflammatory myofibroblastic tumor treated with combined laparoscopic and endoscopic gastric wedge resection: a case report. World J Surg Oncol 2018; 16:161. [PMID: 30089486 PMCID: PMC6083513 DOI: 10.1186/s12957-018-1460-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/01/2018] [Indexed: 12/02/2022] Open
Abstract
Background Inflammatory myofibroblastic tumor is an uncommon soft tissue neoplasm rarely reported in the stomach. Case presentation We identified a tumor highly suggestive of poorly differentiated gastric adenocarcinoma in the lesser curvature of the stomach of a 53-year-old female during screening endoscopy. Although the patient’s gastric biopsy did not reveal cancer, the tumor configuration was strongly suspicious for malignancy, and we performed a gastric wedge resection using a combined laparoscopic and endoscopic method. The lesion was diagnosed as inflammatory myofibroblastic tumor based on its morphological and immunohistological features. Conclusions Inflammatory myofibroblastic tumor should be considered in the differential diagnosis of soft tissue tumors in the stomach. We present a case of inflammatory myofibroblastic tumor safely treated with combined laparoscopic and endoscopic gastric wedge resection.
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Affiliation(s)
- Masato Hayashi
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Shuhei Mayanagi
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Rieko Nakamura
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Koichi Suda
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Norihito Wada
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuko Kitagawa
- Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Lee JE, Choi SY, Lee HK, Yi BH, Lee MH, Lee S, Lee SJ, Lee J, Jeong WK. Computed tomographic features of inflammatory myofibroblastic tumour of the stomach in adult patients: An analysis of five multicentre cases with literature review. J Med Imaging Radiat Oncol 2018; 62:769-776. [DOI: 10.1111/1754-9485.12780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/04/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Ji Eun Lee
- Department of Radiology; Soonchunhyang University College of Medicine; Bucheon Hospital; Bucheon Korea
| | - Seo-Youn Choi
- Department of Radiology; Soonchunhyang University College of Medicine; Bucheon Hospital; Bucheon Korea
| | - Hae Kyung Lee
- Department of Radiology; Soonchunhyang University College of Medicine; Bucheon Hospital; Bucheon Korea
| | - Boem Ha Yi
- Department of Radiology; Soonchunhyang University College of Medicine; Bucheon Hospital; Bucheon Korea
| | - Min Hee Lee
- Department of Radiology; Soonchunhyang University College of Medicine; Bucheon Hospital; Bucheon Korea
| | - Sunyoung Lee
- Department of Radiology and Center for Imaging Science; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
- Department of Radiology and Research Institute of Radiology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - So Jung Lee
- Department of Radiology and Research Institute of Radiology; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - Jisun Lee
- Department of Radiology; Chungbuk National University Hospital; Cheongju Korea
| | - Woo Kyoung Jeong
- Department of Radiology and Center for Imaging Science; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
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Fan J, Huang B, Yang X, Yang M, He J, Nie X. ALK-positive gastric inflammatory myofibroblastic tumor in an adult with familial adenomatous polyposis and diffuse fundic polyposis. Diagn Pathol 2017; 12:68. [PMID: 28923119 PMCID: PMC5604288 DOI: 10.1186/s13000-017-0645-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 07/17/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) of the stomach is extremely rare in adults and exhibits a variable biological behavior that ranges from frequently benign lesions to more aggressive variants. Here we report a case of gastric IMT with lymph node metastasis in an adult who had undergone total colectomy for familial adenomatous polyposis (FAP). CASE PRESENTATION A 37-year-old man presented gradual-onset epigastric discomfort; he had undergone total colectomy for FAP 6 years before. The upper endoscopy revealed diffuse polyposis in the body of stomach and a submucosal protruding tumor of approximately 4.5 × 3.5 cm in the gastric angular incisure, appearing like gastrointestinal stromal tumor. Histology after surgery verified the diagnosis of fundic gland polyposis (FGPs) and gastric IMT with lymph node metastasis. Both the primary IMT tissue and its metastatic lesion but not the FGP or FAP tissue were positive for anaplastic lymphoma kinase (ALK) on immunohistochemical staining. Fluorescent in situ hybridization confirmed the existence of ALK rearrangement in IMT tissues. However, the patient exhibited no abnormalities in microsatellite instability or mismatch repair-system components, including MSH6, MSH2, MLH1 and PMS2, in IMT, FGP or FAP tissue. CONCLUSIONS This case allowed for exploring the relationship among IMT, FGP and FAP and indicates that gastric IMT should be considered in the diagnosis of a gastric mass in patients with FAP. ALK may be a useful biomarker in the diagnosis of IMT and its metastatic lesions.
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Affiliation(s)
- Jun Fan
- Department of pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Bo Huang
- Department of pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiuping Yang
- Department of pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ming Yang
- Department of pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jun He
- Department of pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiu Nie
- Department of pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Mohammad Hoseini-Azar M, Mokhtare M, Zare-Mirzaie A, Gholami A, Agah S, Ghafoori SMS. Fever,Weight Loss and Early Satiety due to Gastric Inflammatory Myofibroblastic Tumor; Case Report and Literature Review. Middle East J Dig Dis 2016; 8:138-42. [PMID: 27252821 PMCID: PMC4885613 DOI: 10.15171/mejdd.2016.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Gastric inflammatory myofibroblastic tumor (IMT) is a rare tumor with and
unpredictable prognosis usually find in young adults. We present an 18-yearold
man with gastric IMT. He complained of epigastric pain, intermittent fever
and night sweating associated with weight loss since two years ago. Physical
examination showed anemic and cachestic features with mild abdominal tenderness
in palpitation as well as an abdominal mass in epigastrium. Abdominal
CT scan revealed a huge mass that was arising from the stomach. Upper endoscopy
revealed a submucosal lesion in fundus of stomach of approximately
8cm. Endoscopic ultrasound showed a large sub-mucosal non homogenous
fundal mass with areas of calcification. The patient underwent laparoscopic
partial gastrectomy. Histopathologyand immunohistochemistryevaluation revealed
an IMT.
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Affiliation(s)
| | - Marjan Mokhtare
- Assistant Professor, Colorectal Research center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zare-Mirzaie
- Associate Professor,Department of Pathology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Gholami
- Assistant Professor,Department of Internal Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shahram Agah
- Professor, Colorectal Research center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Sadegh Ghafoori
- Medical student, Colorectal Research center, Medical Student Research Committee (MSRC), Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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12
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Lu H, Shen H, Shen XQ, Chen Q, Wu SC, Lv Y. Inflammatory myofibroblastic tumor of the hand: A case report. Oncol Lett 2015; 9:2548-2550. [PMID: 26137104 DOI: 10.3892/ol.2015.3141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 03/13/2015] [Indexed: 12/16/2022] Open
Abstract
The present study reports the case of a 58-year-old male patient who repeatedly presented with hand ulcers that were diagnosed as cellulitis. Upon histological analysis, however, an inflammatory myofibroblastic tumor (IMT) was diagnosed. IMTs rarely occur in the hands. The involved tissue was removed with the tumor, with the exception of the tendons and cutaneous nerve. The involved tendon sheath and epineurium were carefully resected. After 2 years of follow-up, the patient showed no signs of tumor recurrence and the hand function was good. IMTs in the hands are relatively rare, and are often easily misdiagnosed as infection. An early and correct diagnosis is the key to successful treatment. A biopsy is necessary following debridement of the infected lesion, particularly for recurrent infected lesions. The surgical approach should be conservative, in order to maintain maximum hand function.
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Affiliation(s)
- Hui Lu
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Hui Shen
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Xiang-Qian Shen
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Qiang Chen
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Shou-Cheng Wu
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Ying Lv
- Department of Neonatology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
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13
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Kim DJ, Kim W. Inflammatory myofibroblastic tumor treated with laparoscopic proximal gastrectomy and double-tract anastomosis. J Gastric Cancer 2015; 15:64-7. [PMID: 25861525 PMCID: PMC4389099 DOI: 10.5230/jgc.2015.15.1.64] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 09/17/2014] [Accepted: 10/01/2014] [Indexed: 12/18/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) of the stomach are extremely rare in adults, and their oncologic prognosis is not well understood. We present a 28-year-old man with a proximal gastric IMT. The patient visited the emergency department of Yeouido St. Mary's Hospital with syncope and hematemesis. Hemoglobin levels were <5.5 g/dl. Gastric fibroscopy showed a protruding mass 4×4 cm in size, with central ulceration on the posterior wall of the fundus and diffuse wall thickening throughout the cardia and anterior wall of the upper body. Endoscopic biopsy revealed indeterminate spindle cells, along with inflammation. Given the risk of rebleeding, an operation was performed despite the uncertain diagnosis. Because the mass was circumferential, laparoscopic proximal gastrectomy and double-tract anastomosis were performed to ensure a safe resection margin. The pathological diagnosis was consistent with an IMT originating from the stomach, although the tumor was negative for anaplastic lymphoma kinase gene mutation.
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Affiliation(s)
- Dong Jin Kim
- Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Wook Kim
- Department of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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