Inflammatory Myofibroblastic Tumor of Colon Mimicking Advanced Malignancy: Report of Two Cases with Review of Literature

Abstract

Inflammatory myofibroblastic tumor (IMT) is mostly found in lungs of children and young adults. However, extrapulmonary IMT can be found in all age groups. A 47-year-old female presented with large anterior abdominal wall mass with fecal fistula from the transverse colon. She underwent wide local excision including tumor mass along with involved parietal wall excision with segmental transverse colectomy. In another case, a 43-year-old male patient presented with acute large intestinal obstruction due to IMT in the sigmoid colon. He underwent emergency subtotal colectomy. The clinical and radiological features of both patients were suggestive of the malignant disease. However, histopathology and immunohistochemistry (IHC) reports were confirmatory of IMT. Their postoperative recovery was uneventful, and they are under regular follow-up for the last 2 years without any evidence of recurrence. On literature review, we found that IMT of the colon is a very rare presentation. Also, patients with IMT of the colon may present differently. It appears like malignancy on clinical and radiological findings, and only histopathology with IHC can confirm its diagnosis. Complete surgical excision is the treatment of choice, and patients need regular follow-up in postoperative period in view of its nature of recurrence.