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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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Ali AA, Khurshid DH, Shareef FO, Abdul Aziz JM, Majeed NG. A Huge Abdominal Wall Inflammatory Myofibroblastic Tumor: A Report of a Rare Case and Literature Review. Cureus 2024; 16:e54795. [PMID: 38529455 PMCID: PMC10961601 DOI: 10.7759/cureus.54795] [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] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
An inflammatory myofibroblastic tumor (IMT), frequently misdiagnosed as a malignant neoplasm, is a rare tumor characterized by the presence of myofibroblastic spindle cells and infiltration of inflammatory cells. In the current study, a 49-year-old female patient with a huge abdominal mass in the left abdominal wall was examined. Diagnostic procedures included blood tests, as well as ultrasound, Doppler, and computed tomography (CT) scans, which revealed the presence of a huge complex multiloculated cystic lesion measuring 30 x 37 x 20 cm. The patient underwent complete excision of the mass. Histopathological examination confirmed the benign nature of the tumor and revealed no evidence of malignancy. A comprehensive review of the available literature shows that the current case is one of the few documented cases. The report concluded by emphasizing the importance of surgical intervention as the primary therapeutic strategy and the crucial role of histopathology in the diagnostic process.
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Affiliation(s)
- Aqeed A Ali
- Biomedical Sciences, Komar University of Science and Technology, Sulaymaniyah, IRQ
- Surgery, Sulaimani Teaching Hospital, Sulaymaniyah, IRQ
| | | | | | - Jeza M Abdul Aziz
- Baxshin Research Center, Baxshin Hospital, Sulaymaniyah, IRQ
- Biomedical Sciences, Komar University of Science and Technology, Sulaymaniyah, IRQ
| | - Nasreen G Majeed
- Obstetrics and Gynaecology, Baxshin Hospital, Sulaymaniyah, IRQ
- Nursing, Azmar Technical and Vocational Institute, Sulaymaniyah, IRQ
- Research Center, University of Halabja, Halabja, IRQ
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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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A Recurrent Inflammatory Myofibroblastic Tumor-like Lesion of the Splenic Capsule in a Kitten: Clinical, Microscopic and Ultrastructural Description. Vet Sci 2021; 8:vetsci8110275. [PMID: 34822648 PMCID: PMC8621069 DOI: 10.3390/vetsci8110275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe the findings of an unusual splenic tumor in a kitten. METHODS A grossly multinodular mass arising from the splenic capsule of a 7-month-old male Havana kitten was echographically detected and surgically removed by splenectomy, then analyzed microscopically and ultrastructurally. RESULTS The mass showed features of an inflammatory myofibroblastic tumor. TREATMENT AND OUTCOME Two months after surgical excision, the mass recurred in the same intra-abdominal area but disappeared after 2 months of anti-inflammatory therapy. Follow-up at 18 months after surgery revealed resolution of the disease. CLINICAL RELEVANCE Inflammatory myofibroblastic tumor in cats have been rarely reported and are usually in the orbital region. In the present report, an unusual multinodular gross presentation, a recurrence over time, and a favorable clinical course, are described.
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Coelho VV, Surendran S, Roopavathana B, Chase S. Colonic inflammatory myofibroblastic tumour presenting as 'pyrexia of unknown origin': report of a rare disease and its unique presentation. BMJ Case Rep 2020; 13:13/12/e236056. [PMID: 33298475 DOI: 10.1136/bcr-2020-236056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
An intra-abdominal inflammatory myofibroblastic tumour (IMT) belongs to a rare group of diseases initially described as an inflammatory pseudotumour. Even though it is seen more often in children, its incidence in adults is even rarer. Clinical presentations can vary depending on its site and inherent tumour properties. The colon is an uncommon site for IMT and pyrexia of unknown origin (PUO) as its dominant clinical presentation is even rarer. A 27-year-old woman presented with PUO. She was evaluated under the department of internal medicine before undergoing an 18F-fluorodeoxyglucose positron emission tomography-computed tomography scan. This showed an intensely enhancing descending colon mass. An image-guided biopsy of this lesion was reported as IMT. She underwent a left hemicolectomy and complete excision of the tumour, following which her symptoms resolved completely. The patient has been disease-free at a 6-month follow-up and is asymptomatic at 1 year.
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Affiliation(s)
- Victor Vijay Coelho
- General Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Suraj Surendran
- General and Upper Gastrointestinal Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Beulah Roopavathana
- General Surgery Unit IV, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - Suchita Chase
- General Surgery Unit IV, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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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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Albayrak F, Dursun H, Albayrak Y, Altas S, Uyanik A, Yildirim R. Inflammatory Myofibroblastic Tumor of the Stomach in an Adult Woman: A Rare Intermittent Cause of Gastric Outlet Obstruction. TUMORI JOURNAL 2018; 96:492-5. [DOI: 10.1177/030089161009600320] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Inflammatory myofibroblastic tumor is a neoplasm of intermediate biological potential that frequently recurs and rarely metastasizes. Case report We report a rare case of intermittent gastric outlet obstruction by an inflammatory myofibroblastic tumor of the cardia. Results A 56-year-old woman presented at the gastroenterology department with a two-day history of hematemesis and melena. She had intermittent nausea and vomiting complaints, which had manifested periodically for about five months. Upper gastrointestinal endoscopy demonstrated a mass of 6 cm in diameter, which was resected. Histological examination revealed ulcerated mucosal granulation-like tissue with myofibroblastic spindle cell proliferation in a storiform pattern. Conclusions In order to avoid unnecessary aggressive therapy, gastric IMT should be taken into account when a gastric mass accompanied by the various clinical manifestations of IMT is found in an adult.
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Affiliation(s)
- Fatih Albayrak
- Department of Internal Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Hakan Dursun
- Department of Internal Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Yavuz Albayrak
- Department of General Surgery and Burn Unit, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Sare Altas
- Department of Pathology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Abdullah Uyanik
- Department of Internal Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Rahsan Yildirim
- Department of Internal Medicine, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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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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14
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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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15
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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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16
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Inflammatory myofibroblastic tumor of the thigh: presentation of a rare case and review of the literature. Case Rep Orthop 2015; 2015:814241. [PMID: 25945274 PMCID: PMC4402203 DOI: 10.1155/2015/814241] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/14/2015] [Indexed: 01/28/2023] Open
Abstract
Inflammatory myofibroblastic tumors are uncommon neoplasms; presentation of these tumors in the lower extremities is extremely rare. We present a case of a 47-year-old male with fever, fatigue, and a slow-growing thigh mass. The inflammatory markers were elevated and the MR images showed a well-defined intermuscular lesion with mild heterogeneous enhancement. The lesion was excised and histologic examination was consistent with an inflammatory myofibroblastic tumor. No adjuvant therapy was needed and the patient remained asymptomatic with no evidence of tumor recurrence during the 2 years of follow-up.
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17
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Qiu JF, Shi YJ, Fang L, Wang HF, Zhang MC. High fever as an initial symptom of primary gastric inflammatory myofibroblastic tumor in an adult woman. Int J Clin Exp Med 2014; 7:1468-1473. [PMID: 24995114 PMCID: PMC4073775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 05/09/2014] [Indexed: 06/03/2023]
Abstract
Inflammatory myofibroblastic tumor, also known as inflammatory pseudotumor, plasma cell granuloma or inflammatory myofibroblastoma, is characterized histopathologically by myofibroblastic spindle cells with inflammatory cell infiltrates composed of plasma cells, lymphocytes and eosinophils. Inflammatory myofibroblastic tumor is typically seen in children or young adults and is most commonly localized to the lungs, but it can occur anywhere in the body. To date, however, only a few cases involving the stomach have been reported. Herein, we present a case of gastric inflammatory myofibroblastic tumor in an adult woman with an initial symptom of high fever.
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Affiliation(s)
- Jiang-Feng Qiu
- Department of Gastrointestinal Surgery, Ningbo First Hospital Ningbo, 315010, China
| | - Yi-Jiu Shi
- Department of Gastrointestinal Surgery, Ningbo First Hospital Ningbo, 315010, China
| | - Lei Fang
- Department of Gastrointestinal Surgery, Ningbo First Hospital Ningbo, 315010, China
| | - Hui-Fang Wang
- Department of Gastrointestinal Surgery, Ningbo First Hospital Ningbo, 315010, China
| | - Mou-Cheng Zhang
- Department of Gastrointestinal Surgery, Ningbo First Hospital Ningbo, 315010, China
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18
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Katakwar A, Gedam BS, Mukewar S, Agasti A. Primary gastric inflammatory myofibroblastic tumor in an adult-case report with brief review. Indian J Surg Oncol 2014; 5:66-70. [PMID: 24669167 DOI: 10.1007/s13193-014-0296-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 01/27/2014] [Indexed: 12/13/2022] Open
Abstract
The term inflammatory myofibroblastic tumor more commonly referred to as "pseudostumor ", denotes a pseudosarcomatous inflammatory lesion that contains spindle cells, myofibroblasts, plasma cells, lymphocytes and histiocytes. It exhibits a variable biological behavior that ranges from frequently benign lesions to more aggressive variants. Inflammatory myofibroblastic tumor (IMT) of the stomach is extremely rare and its prognosis is unpredictable. We present a 45-year-old diabetic man with a gastric Inflammatory myofibroblastic tumor. The histopathological and immunohistochemical analysis was the key to reach diagnosis.
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Affiliation(s)
- Abhishek Katakwar
- Department of Surgical Gastroenterology, Midas Multispecialty Hospital and Research Centre, Nagpur, India 440010 ; Midas Multispecialty Hospital Pvt. Ltd., Ramdaspeth, Central Bazaar Road, Nagpur, Maharashtra India 440010
| | - B S Gedam
- Department of Surgical Gastroenterology, Midas Multispecialty Hospital and Research Centre, Nagpur, India 440010
| | - Shrikant Mukewar
- Department of Medical Gastroenterology, Midas Multispecialty Hospital and Research Centre, Nagpur, India 440010
| | - Ananta Agasti
- Department of Medical Gastroenterology, Midas Multispecialty Hospital and Research Centre, Nagpur, India 440010
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19
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Bjelovic M, Micev M, Spica B, Babic T, Gunjic D, Djuric A, Pesko P. Primary inflammatory myofibroblastic tumor of the stomach in an adult woman: a case report and review of the literature. World J Surg Oncol 2013; 11:35. [PMID: 23374227 PMCID: PMC3570320 DOI: 10.1186/1477-7819-11-35] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 01/13/2013] [Indexed: 12/30/2022] Open
Abstract
Inflammatory myofibroblastic tumor has been defined as a histologically distinctive lesion with uncertain behaviour. The term inflammatory myofibroblastic tumor more commonly referred to as "pseudostumor ", denotes a pseudosarcomatous inflammatory lesion that contains spindle cells, myofibroblasts, plasma cells, lymphocytes and histiocytes. It exhibits a variable biological behavior that ranges from frequently benign lesions to more aggressive variants. Inflammatory myofibroblastic tumor mostly occurs in the soft tissue of children and young adults, and the lungs are the most commonly affected site, but it has been recognized that any anatomic localization can be involved. Inflammatory myofibroblastic tumors in adults are very rare, especially in the stomach. We present a case of a 43-year old woman with primary inflammatory myofibiroblastic tumor in the stomach and a review of the literature.
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20
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Rare gastric inflammatory myofibroblastic tumor in an adult woman: a case report with review of the literature. Case Rep Med 2012; 2012:374070. [PMID: 22570660 PMCID: PMC3337595 DOI: 10.1155/2012/374070] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 02/15/2012] [Indexed: 12/29/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) of the stomach is extremely rare and its prognosis is unpredictable. We present a 37-year-old woman with a gastric IMT. She presented epigastric pain since 2 months, anemia and weight loss associated. Physical examination showed cutaneous pallor and mild abdominal tenderness in the epigastrium. Abdominal ultrasonography showed a tumor near the pancreas and the CT scan revealed that the lesion was arising from the stomach. Upper endoscopy showed a submucosal lesion of approximately 7.5 cm located in the posterior wall of the gastric body such as a gastrointestinal stromal tumor (GIST). The patient underwent a subtotal gastrectomy and Billroth I reconstruction. The histopathological and immunohistochemical analysis revealed an IMT that originated from the gastric wall.
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21
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Papadopoulou D, Chatziralli I, Papadopoulos V, Filitantzi C, Demertzidis C. Synchronous gastric inflammatory myofibroblastic tumour with gastrointestinal stromal tumour of the stomach and hepatic syringious haemangioma. J Surg Case Rep 2012; 2012:7. [PMID: 24960722 PMCID: PMC3649450 DOI: 10.1093/jscr/2012.1.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Inflammatory myofibroblastic tumour of the stomach is a very rare lesion. A case of a gastric inflammatory myofibroblastic tumour associated with gastrointestinal stromal tumour of the stomach and hepatic syringious haemangioma is described. We report an 80-year-old male who had an exophytic mass in the area of the pylorus and the duodenum, where hepatic cysts were found in the magnetic resonance (MRI) scan on examination of hypochromic microcytic anaemia, and prolapsus and torsion of the bulb of the stomach found during gastroscopy. During surgical excision of the exophytic mass, a gastrointestinal stromal tumour from the gastric fundus and a syringious haemangioma from the superior hepatic surface were resected. All tumours were treated successfully by surgical excision. The patient had an uneventful recovery. Neither recurrence nor metastasis was found after a 12-month follow-up. To our knowledge, this is the first time that such an association is reported in the literature.
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22
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Rezaii Salim M, Vahedi H, Salimi Z, Froutan H, Sotoudeh M. Inflammatory myofibroblastic tumor of the small bowel: a case report. Middle East J Dig Dis 2011; 3:134-7. [PMID: 25197546 PMCID: PMC4154918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 12/25/2010] [Indexed: 11/23/2022] Open
Abstract
Inflammatory Myofibroblastic Tumor (IMT) is a rare neoplastic lesion with tendency toward local aggressive behavior and recurrence. The tumor most commonly occurs in the pulmonary system of children and young adult, although it may rarely develop in older patients and other organs. Symptoms are non-specific and depend on the location of the tumor. The gastrointestinal tract is rarely the primary site of origin for this lesion. We report an unusual presentation of this rare lesion in a 58 year old woman with intussusception and partial intestinal obstruction.
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Affiliation(s)
- Maryam Rezaii Salim
- 1Digestive Diseases Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran;
| | - Homayoon Vahedi
- 1Digestive Diseases Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran;
| | - Zia Salimi
- 2Department of Pathology and Laboratory Medicine, Tehran Clinic Hospital, Tehran, Iran
| | - Hossein Froutan
- 3Department of Gastroenterology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Sotoudeh
- 1Digestive Diseases Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran;
,4Department of Pathology and Laboratory Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
,Corresponding Author: Masoud Sotoudeh, MD, Professor, Department of Pathology and Laboratory Medicine, Shariati Hospital, Tehran University of Medical Sciences Tehran, Iran. Tel:+9821 8490 2205 Fax: +9821 8490 2192
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23
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Kwak JM, Kim J, Suh SO. Anterograde jejunojejunal intussusception resulted in acute efferent loop syndrome after subtotal gastrectomy. World J Gastroenterol 2010; 16:3472-4. [PMID: 20632454 PMCID: PMC2904898 DOI: 10.3748/wjg.v16.i27.3472] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Postoperative intussusception is an unusual clinical entity in adults, and is rarely encountered as a complication following gastric surgery. The most common type after gastric surgery is retrograde jejunogastric intussusception, and jejunojejunal intussusception has been rarely reported. We report a case of anterograde jejunojejunal intussusception after radical subtotal gastrectomy with Billroth II anastomosis in a 38-year-old Korean woman with early gastric cancer, and include a review of the literature on this unusual complication.
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