Abstract
Introduction
Inflammatory myofibroblastic tumor (IMT) is a rare low-grade malignant mesenchymal tumor, which can occur at any location, although the lung is the most commonly affected organ. It is extremely rare in the duodenum and only two cases have been reported previously. We report, to our knowledge, the first case of multiple neoplastic lesions.
Case report
A 20-year-old male presented with the chief complaints of intermittent right epigastric pain, nausea and vomiting. Imaging examination, electronic gastroscopy and preoperative biopsy revealed undefined lesions in the duodenum. Pancreaticoduodenectomy was performed and diagnosis of multiple IMT was confirmed by pathological biopsy of the excised tumor. A satisfactory outcome was proved by the follow-up 1 year after curative operation.
Conclusion
IMT can be diagnosed by histological examination and immunohistochemical test after surgical resection. Patients can benefit from radical resection with favorable prognosis.
References
Coffin CM, Humphrey PA, Dehner LP. Extrapulmonary inflammatory myofibroblastic tumor: a clinical and pathological survey. Semin Diagn Pathol. 1998 May;15(2):85–101.
Coffin CM, Watterson J, Priest JR, Dehner LP. Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol. 1995 Aug;19(8):859–72.
Rabban JT, Zaloudek CJ, Shekitka KM, Tavassoli FA. Inflammatory myofibroblastic tumor of the uterus: a clinicopathologic study of 6 cases emphasizing distinction from aggressive mesenchymal tumors. Am J Surg Pathol. 2005 Oct;29(10):1348–55.
Tsuzuki T, Magi-Galluzzi C, Epstein JI. ALK-1 expression in inflammatory myofibroblastic tumor of the urinary bladder. Am J Surg Pathol. 2004 Dec;28(12):1609–14.
Wynn GR, Giles A, Steger AS, Wilkinson ML. Case report: inflammatory myofibroblastic tumor of the duodenum. J Gastrointest Cancer. 2008;39(1–4):79–81.
Gómez-Román JJ, Sánchez-Velasco P, Ocejo-Vinyals G, Hernández-Nieto E, Leyva-Cobián F, Val-Bernal JF. Human herpesvirus-8 genes are expressed in pulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). Am J Surg Pathol. 2001 May;25(5):624–9.
Cassivi SD, Wylam ME. Pulmonary inflammatory myofibroblastic tumor associated with histoplasmosis. Interact Cardiovasc Thorac Surg. 2006 Aug;5(4):514–6.
Corapçioğlu F, Kargi A, Olgun N, Ozer E, Olguner M, Sarialioğlu F. Inflammatory myofibroblastic tumor of the ileocecal mesentery mimicking abdominal lymphoma in childhood: report of two cases. Surg Today. 2005;35(8):687–91.
Moriyama S, Inayoshi A, Kurano R. Inflammatory pseudotumor of the spleen: report of a case. Surg Today. 2000;30(10):942–6.
Copin MC, Gosselin BH, Ribet ME. Plasma cell granuloma of the lung: difficulties in diagnosis and prognosis. Ann Thorac Surg. 1996 May;61(5):1477–82.
Cerfolio RJ, Allen MS, Nascimento AG, Deschamps C, Trastek VF, Miller DL, Pairolero PC. Inflammatory pseudotumors of the lung. Ann Thorac Surg. 1999 Apr;67(4):933–6.
Gal AA, Koss MN, McCarthy WF, Hochholzer L. Prognostic factors in pulmonary fibrohistiocytic lesions. Cancer. 1994 Apr 1;73(7):1817–24.
Takeda S, Onishi Y, Kawamura T, Maeda H. Clinical spectrum of pulmonary inflammatory myofibroblastic tumor. Interact Cardiovasc Thorac Surg. 2008 Aug;7(4):629–33.
Meis JM, Enzinger FM. Inflammatory fibrosarcoma of the mesentery and retroperitoneum. A tumor closely simulating inflammatory pseudotumor. Am J Surg Pathol. 1991 Dec;15(12):1146–56.
Imabun S, Namba M, Kina M, Uetsu M, Hoshida Y. Inflammatory pseudotumor of the abdomen: report of a case. Surg Today. 1998;28(11):1172–4.
Dishop MK, Warner BW, Dehner LP, Kriss VM, Greenwood MF, Geil JD, Moscow JA. Successful treatment of inflammatory myofibroblastic tumor with malignant transformation by surgical resection and chemotherapy. J Pediatr Hematol Oncol. 2003 Feb;25(2):153–8.
Hussain SF, Salahuddin N, Khan A, Memon SS, Fatimi SH, Ahmed R. The insidious onset of dyspnea and right lung collapse in a 35-year-old man. Chest. 2005 May;127(5):1844–7.
Lawrence B, Perez-Atayde A, Hibbard MK, Rubin BP, Dal Cin P, Pinkus JL, Pinkus GS, Xiao S, Yi ES, Fletcher CD, Fletcher JA. TPM3-ALK and TPM4-ALK oncogenes in inflammatory myofibroblastic tumors. Am J Pathol. 2000 Aug;157(2):377–84.
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Xiang, J., Liu, X., Wu, S. et al. Multiple Inflammatory Myofibroblastic Tumor of the Duodenum: Case Report and Literature Review. J Gastrointest Surg 16, 1442–1445 (2012). https://doi.org/10.1007/s11605-012-1883-9
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DOI: https://doi.org/10.1007/s11605-012-1883-9