Abstract
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.
References
Brunn, H., Two interesting benign lung tumors of contradictory histopathology. J Thorac Surg, 1939. 9: p. 119–131.
Diaz-Torne, C., et al., Inflammatory pseudotumor of the liver associated with rheumatoid arthritis. Arthritis Rheum, 2007. 57(6): p. 1102–6.
McHenry, C.R., et al., Inflammatory pseudotumor of the spleen: a rare entity that may mimic hematopoietic malignancy. Am Surg, 1995. 61(12): p. 1067–71.
Chen, S.S., et al., Mesenteric inflammatory myofibroblastic tumors in an elder patient with early recurrence: a case report. World J Gastroenterol, 2007. 13(26): p. 3645–8.
Vaughan, K.G., et al., Mesenteric inflammatory pseudotumor as a cause of abdominal pain in a teenager: presentation and literature review. Pediatr Surg Int, 2005. 21(6): p. 497–9.
Cho, A.H., et al., Inflammatory pseudotumor of temporal bone with pachymeningitis, cranial neuropathies and uveitis. Eur Neurol, 2004. 51(4): p. 238–40.
Uy, H.S., et al., Sclerosing inflammatory pseudotumor of the eye. Arch Ophthalmol, 2001. 119(4): p. 603–7.
Burke, A., et al., Cardiac inflammatory myofibroblastic tumor: a “benign” neoplasm that may result in syncope, myocardial infarction, and sudden death. Am J Surg Pathol, 2007. 31(7): p. 1115–22.
Koirala, R., et al., Retroperitoneal inflammatory myofibroblastic tumor. Am J Surg, 2010. 199(2): p. e17–9.
Gleason, B.C. and J.L. Hornick, Inflammatory myofibroblastic tumours: where are we now? J Clin Pathol, 2008. 61(4): p. 428–37.
Pulford, K., et al., Immune response to the ALK oncogenic tyrosine kinase in patients with anaplastic large-cell lymphoma. Blood, 2000. 96(4): p. 1605–7.
Vaglio, A., C. Salvarani, and C. Buzio, Retroperitoneal fibrosis. Lancet, 2006. 367(9506): p. 241–51.
Kutluk, T., et al., Mesenteric inflammatory pseudotumor: unusual presentation with leukemoid reaction and massive calcified mass. J Pediatr Hematol Oncol, 2002. 24(2): p. 158–9.
Miyazaki, H., et al., Inflammatory pseudotumor of the mesentery causing portal venous thrombosis and cavernomatous transformation. Intern Med, 2002. 41(8): p. 633–7.
Sawant, S., L. Kasturi, and A. Amin, Inflammatory myofibroblastic tumor. Indian J Pediatr, 2002. 69(11): p. 1001–2.
Treissman, S.P., et al., Omental-mesenteric inflammatory pseudotumor. Cytogenetic demonstration of genetic changes and monoclonality in one tumor. Cancer, 1994. 73(5): p. 1433–7.
Uysal, S., et al., Inflammatory pseudotumor of the sigmoid colon mesentery: US and CT findings (2004:12b). Eur Radiol, 2005. 15(3): p. 633–5.
Coffin, C.M., et al., Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol, 1995. 19(8): p. 859–72.
Fletcher, C.D., Unni, K.K., Mertens, F. (eds), Pathology and Genetics of Tumors of Soft Tissue and Bone. World Health Organization Classification of Tumours. 2002, Lyon: IARC Press. 91–93.
Arber, D.A., et al., Frequent presence of the Epstein-Barr virus in inflammatory pseudotumor. Hum Pathol, 1995. 26(10): p. 1093–8.
Evans, J., et al., Inflammatory pseudotumour secondary to actinomyces infection. Aust N Z J Surg, 1999. 69(6): p. 467–9.
Rathinam, S., et al., Inflammatory myofibroblastic tumour at the pacemaker site. Interact Cardiovasc Thorac Surg, 2010. 10(3): p. 443–5.
Manganelli, P., et al., Clinical and histological coexistence of inflammatory pseudotumour of the lymph nodes and rheumatoid arthritis. Clin Rheumatol, 2003. 22(6): p. 467–71.
Hoene, K.A., et al., Inflammatory myofibroblastic tumor of the urinary bladder in a 27-year-old woman with systemic lupus erythematosus. Int J Urol, 2008. 15(2): p. 182–4.
Chang, Y., et al., Inflammatory pseudotumor of the choroid plexus in Sjogren’s disease. Neurosurgery, 1991. 29(2): p. 287–90.
Cush, J.J., I.H. Leibowitz, and S.A. Friedman, Adult-onset Still’s disease and inflammatory orbital pseudotumor. N Y State J Med, 1985. 85(3): p. 110–1.
Coffin, C.M., J.L. Hornick, and C.D. Fletcher, Inflammatory myofibroblastic tumor: comparison of clinicopathologic, histologic, and immunohistochemical features including ALK expression in atypical and aggressive cases. Am J Surg Pathol, 2007. 31(4): p. 509–20.
Jiang, Y.H., et al., Comparison of the clinical and immunohistochemical features, including anaplastic lymphoma kinase (ALK) and p53, in inflammatory myofibroblastic tumours. J Int Med Res, 2009. 37(3): p. 867–77.
Meis, J.M. and F.M. Enzinger, Inflammatory fibrosarcoma of the mesentery and retroperitoneum. A tumor closely simulating inflammatory pseudotumor. Am J Surg Pathol, 1991. 15(12): p. 1146–56.
Chun, Y.S., et al., Pediatric inflammatory myofibroblastic tumor: anaplastic lymphoma kinase (ALK) expression and prognosis. Pediatr Blood Cancer, 2005. 45(6): p. 796–801.
Favini, F., et al., Inflammatory myofibroblastic tumor of the conjunctiva: response to chemotherapy with low-dose methotrexate and vinorelbine. Pediatr Blood Cancer, 2010. 54(3): p. 483–5.
Kovach, S.J., et al., Inflammatory myofibroblastic tumors. J Surg Oncol, 2006. 94(5): p. 385–91.
Butrynski, J.E., et al., Crizotinib in ALK-rearranged inflammatory myofibroblastic tumor. N Engl J Med, 2010. 363(18): p. 1727–33.
Dagash, H., et al., Inflammatory myofibroblastic tumor of the pancreas: a case report of 2 pediatric cases--steroids or surgery? J Pediatr Surg, 2009. 44(9): p. 1839–41.
Li, J.Y., et al., Bilateral renal inflammatory pseudotumour effectively treated with corticosteroid. Clin Exp Nephrol, 2010. 14(2): p. 190–8.
Hoover, S.V., et al., Plasma cell granuloma of the lung, response to radiation therapy: report of a single case. Cancer, 1977. 39(1): p. 123–5.
Imperato, J.P., et al., Treatment of plasma cell granuloma of the lung with radiation therapy. A report of two cases and a review of the literature. Cancer, 1986. 57(11): p. 2127–9.
Yu, D.C., et al., Primary lung tumors in children and adolescents: a 90-year experience. J Pediatr Surg, 2010. 45(6): p. 1090–5.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Choi, A.H., Bohn, O.L., Beddow, T.D. et al. Inflammatory Myofibroblastic Tumor of the Small Bowel Mesentery: An Unusual Cause of Abdominal Pain and Uveitis. J Gastrointest Surg 15, 584–588 (2011). https://doi.org/10.1007/s11605-010-1408-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11605-010-1408-3