Inflammatory myofibroblastic tumor within ileal intussusception as the cause of recurrent abdominal pain in a 57-year old patient

Adult Mid Ileo-Ileal Intussusception Secondary to Inflammatory Myofibroblastic Tumor (IMT): A Case Report and Literature Review

The intestinal intussusception as a cause of bowel obstruction in adult is a rare finding and is a heralder for an underlying lesion. This is in stark contrast to intestinal intussusception in pediatric population where the etiology is always a primary or benign condition and thus bears different outcomes. We hereby present a case of a young female adult, without the presence of any significant comorbidity. She presented with non-specific symptoms of small bowel intussusception. She was diagnosed as a case of adult intussusception with abdominal ultrasonography. The patient underwent complete resection of the tumor, without any reduction attempts, as the best plausible therapeutic approach. Further, in post-operative evaluation, complete pathological analysis of the resected specimen divulged the presence of inflammatory myofibroblastic tumor (IMT) as the underlying lead point of mid-ileo-ileal intussusception.

Atypical Presentation of Intestinal Intussusception Caused by Insidious Inflammatory Myofibroblastic Tumor of the Bowel Wall

Introduction:

Inflammatory myofibroblastic tumor (IMT) is a rare but real tumor, which is histologically characterized by myofibroblastic spindle cells proliferation with inflammatory infiltrate. The lung is the most common affected organ, and extrapulmonary IMTs are less common. However, IMT seldom presents in the gastrointestinal tract, and intussusception is a rare complication of this tumor.

Case presentation:

We documented this rare case of a 12-year-old Chinese girl presenting with abdominal pain. The clinical and radiologic impression was bowel intussusception and bowel obstruction. No sign of abdominal mass was found before surgery, neither physical examination nor radiologic images. Operative findings revealed intestinal intussusception secondary to a little mass. Histopathlogic evaluation of this mass revealed IMT.

Conclusion:

In conclusion, IMT may present with bowel intussusception. However, at the intestinal location, the tumor may be found as an abdominal mass or may be insidious; hence, detailed history, physical examination, and imaging studies are necessary for early recognition and diagnosis.