Mesenteric inflammatory myofibroblastic tumors in an elder patient with early recurrence: A case report

A Huge Abdominal Wall Inflammatory Myofibroblastic Tumor: A Report of a Rare Case and Literature Review

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.

An extremely rare case of malignant jejunal mesenteric inflammatory myofibroblastic tumor in a 61-year-old male patient: A case report and literature review

Introduction

A mesenteric inflammatory myofibroblastic tumor (IMT) is a rare solid tumor of intermediate malignant potential that affects children, adolescents, and young adults predominantly. IMT is mostly encountered in the lung. We report a case of malignant jejunal mesenteric IMT in a 61-year-old male patient who presented with vague abdominal pain and generalized weakness. CT scan revealed a mesenteric mass displacing the attached jejunum. Surgical resection was curative.

Discussion

An extensive literature review was performed to update and further analyze the already available data. A total of 35 cases with mesenteric IMT were reported previously. Only five cases of jejunal mesenteric IMT were reported. Mesenteric IMT demands vast effort to reveal the diagnosis due to its vagueness in the clinical presentation. Mesenteric IMT resembles each other in plenty of pathological and immunohistochemical characteristics.

Conclusion

To the best of our knowledge, this is the first case of malignant jejunal mesenteric IMT in the elderly. Surgical resection was curative.

Spindle cell proliferations of the sigmoid colon, rectum and anus: a review with emphasis on perineurioma

A wide range of spindle cell proliferations are found uncommonly in the sigmoid colon, rectum and anus. They usually present as polyps, and include reactive lesions and benign and malignant neoplasms which may be primary or metastatic. They are less frequently described in the literature compared to those in the upper gastrointestinal tract, and may be underdiagnosed. The widespread use of sigmoidoscopy in symptomatic patients and bowel cancer screening programmes means that histopathologists must be aware of, and adopt a logical approach to, diagnosing spindle cell proliferations in biopsy and polypectomy specimens. This is particularly relevant given the strong association of some mesenchymal polyps with hereditary cancer syndromes. This review article will focus on perineurioma and the recent debate in relation to its overlap with fibroblastic polyp. The clinical, endoscopic, histological and immunohistochemical features of spindle cell proliferations which should be considered in the differential diagnosis of perineurioma will be discussed. There is also a brief reference to malignant spindle cell tumours of diagnostic importance.

Paraduodenal inflammatory pseudotumor masquerading as malignancy

A 30-year-old woman presented with severe abdominal pain and abdominal distension. CT demonstrated two intra-abdominal masses, one involving the left lateral segment of the liver and the other adjacent to the duodenum. Initial biopsies were consistent with focal nodular hyperplasia of the liver and non-specific lymphocytic infiltrate in the paraduodenal mass. Due to persistent symptoms, the patient underwent laparoscopic resection of the paraduodenal mass. Final pathology was consistent with an inflammatory pseudotumour and the patient's symptoms subsequently resolved.

Ultrasonic Manifestations of Mesenteric Inflammatory Myofibroblastic Tumors in Children

Objective: To explore the ultrasonic manifestations of mesenteric inflammatory myofibroblastic tumors (IMTs) in children. Methods: Seven patients with mesenteric IMTs were retrospectively analyzed. The ultrasonic manifestations, such as the locations, sizes, morphology, borders, internal echo, blood flow, and metastasis, of the tumors were detected. Results: In all the seven pediatric patients, a solitary lesion was found for the mesenteric IMTs, including five cases in the ileocecal mesentery and two cases in the mesentery of ascending colon. All the single tumors were revealed as irregular hypoechoic masses with uneven internal echoes and enhanced echoes in the surrounding intestine and omentum. Internal blood flow signals were enriched in the tumors. The borders were clear in five cases and unclear in two cases. In addition, two cases had peritoneal effusion and one case had calcified plaques. In the follow-up studies, one of the seven IMT patients had malignant transformation, and one case was transferred to the pelvic cavity. Conclusion: Ultrasonic examination can clearly demonstrate the locations, sizes, morphology, borders, internal echo, blood flow as well as metastasis of the pediatric IMT of the mesentery, having an important clinical application value as an adjunct to computed tomography (CT).

Highly Vascularized Primarily Inflammatory Pseudotumor of the Omentum in an Adult Male: A Case Report

Patient: Male, 38

Final Diagnosis: Inflammatory myofibroblastic tumor

Symptoms: Abdominal pain • anorexia • weight loss

Medication: —

Clinical Procedure: Operation

Specialty: Surgery

Mesenteric inflammatory pseudotumor: a case report and comprehensive literature review

PURPOSE

This study aims to provide an overview of the literature on mesenteric/omental inflammatory pseudotumors (IPTs).

METHODOLOGY

We present a new case of mesenteric IPT. We also conducted a systematic search of the English-language medical literature using PubMed, Medline, Google, and Google Scholar related to mesenteric or omental IPTs. The following search terms were used in various combinations: inflammatory myofibroblastic tumor, IPT, mesentery, and omentum. The search included articles published in the English language between January, 1978 and April, 2014. Studies were excluded if the full text was unavailable or missing information prohibited comparisons.

RESULTS

A total of 30 reports concerning 36 patients with inflammatory pseudotumors meeting the aforementioned criteria were included. The patients were aged from 10 months to 68 years (mean, 19.98 ± 20.5 years); 12 were female (16.75 ± 16.97 years; range, 10 months to 68 years) and 24 were male (21.6 ± 21.9 years; range, 18 months to 63 years). Detailed clinical and pathologic characteristics of 36 patients with IPTs are provided in Table 1.

CONCLUSION

IPTs may be definitively diagnosed only by histopathological examination and are most effectively treated by resection with negative surgical borders. No consensus has yet been reached regarding when nonsurgical treatment options are most appropriate in management of these lesions. IPTs often recur locally, while distant metastases are very rare. Postoperative close surveillance is essential to detect recurrences early.

Mesenteric myofibroblastic tumor: NSAID therapy after incomplete resection

Myofibroblastic tumors are inflammatory tumors that arise in viscera and soft tissue; their etiopathology is poorly understood. They are capable of infiltration of adjacent organs, local recurrence after surgical resection, and even of distant metastasis. These characteristics result in persistent debate as to the nature of these lesions - whether they are inflammatory or neoplastic, benign or malignant lesions? Diagnosis is almost always made based on histopathological findings. Traditional management is complete surgical excision, but this may be difficult or impossible when the lesion develops in proximity to vital structures. We report the case of a 59-year-old man who was treated in our institution for mesenteric myofibroblastic tumor. Complete resection was not possible due to local infiltration of the mesentery. Recurrence was noted 3 months after surgery; treatment with steroidal and then non-steroidal anti-inflammatory medications (NSAIDs) resulted in clinical and radiologic regression of the tumor.

Inflammatory myofibroblastic tumor of the small bowel mesentery: an unusual cause of abdominal pain and uveitis

INTRODUCTION

An inflammatory myofibroblastic tumor (IMT) of the small bowel mesentery with diffuse immunohistochemical staining for the anaplastic lymphoma kinase 1 gene is reported in a patient who presented with abdominal pain and uveitis.

DISCUSSION

To our knowledge, only seven cases of IMT affecting the small bowel mesentery have previously been reported in the English literature. The association of IMT and uveitis is a rare phenomenon, previously reported in patients with IMT affecting the head and neck. Surgical resection of the IMT resulted in rapid resolution of the uveitis.

CONCLUSION

IMT should be considered in the differential diagnosis for a mesenteric mass.