Gastric Inflammatory Myofibroblastic Tumor with Fludeoxyglucose (18F, FDG) Uptake on Positron Emission Tomography (PET): A Case Report and Literature Review

Abstract

Background: Inflammatory Myofibroblastic Tumor (IMT) is a very rare neoplasm. When Endoscopic Gastroduodenoscopy (EGD) was performed, submucosal tumors of stomach were found incidentally. According to different sources of layer and echogenicity in the Endoscopic Ultrasonography (EUS) finding, submucosal tumors like carcinoid, pancreatic rest, Gastrointestinal Stromal Tumor (GIST), leiomyoma and schwannoma wound be distinguished. However, IMTs are one of submucosal tumors in the stomach. We must put this impression in the differential diagnosis when performing EUS. Case Summary:We present a 55-year-old woman without symptoms who received a health examination, and had a gastric tumor was found during EGD. Initial biopsies showed chronic inflammation. Positron Emission Tomography (PET) showed an increased Fludeoxy Glucose (FDG) uptake in the stomach. Endoscopic ultrasonography was also performed. After surgical intervention, pathological analysis identified an inflammatory myofibroblastic tumor. No recurrence was observed by EGD or a PET scan during the follow-up. The relevant literature from the PubMed database was reviewed, and the clinical presentation, laboratory data, treatment strategies and outcomes of 42 reported cases were analyzed. Forty-two patients with gastric IMTs showed a female predominance (female: male: 26: 16). The most common location of gastric IMTs were gastric bodies (18 of 42). The most common symptoms were abdominal pain (21 of 42). Only two cases were asymptomatic. Tumor recurrence was found in 3 cases after surgical intervention in the reviewed literature. Conclusion:EUS is useful to identify submucosal tumor in the gastrointestinal tract. IMTs must keep in mind when performing EUS.