Inflammatory myofibroblastic tumor of the pancreatic neck: A case report and review of literature

Abstract

BACKGROUND Pancreatic inflammatory myofibroblastic tumor (IMT) is a relatively rare disease that is often confused with pancreatic cancer or pancreatic neuroendocrine tumors. The histological features of IMTs show that tissue from this type of tumor contains an intermingling of fibroblast and myofibroblast proliferation, accompanied by a varying degree of inflammatory cell infiltration. CASE SUMMARY The management of an IMT occurring at the neck of the pancreas is presented in this paper. A 66-year-old female patient was diagnosed with a pancreatic neck mass after a series of tests. The patient underwent enucleation of the pancreatic neck tumor after a pathological diagnosis of IMT. Previous research on the clinical features, pathological diagnosis and treatment of pancreatic IMTs was reviewed. Compared with previous reports, this is a unique case of enucleation of a pancreatic IMT. CONCLUSION The enucleation of pancreatic IMTs may be a safe and efficient surgical method for managing such tumors with a better prognosis. Further cases are required to explore surgical measures for pancreatic IMTs.

Solid pancreatic masses in children: A review of current evidence and clinical challenges

“…Inflammatory myofibroblastic tumors (IMT) are rare mesenchymal tumors of unknown origin most commonly occurring in the lungs of children and adolescents (186). However, they have also been described in the head/neck, liver, pancreas, thyroid, and genitourinary tract (187-191).…”

“…Clinical symptoms are frequently non-specific, though obstructive jaundice may occur in the setting of a pancreatic head lesion (186). Spontaneous splenic rupture has also been reported secondary to the obstruction and congestion of splenic vessels by a pancreatic tail IMT (195).…”

“…IMTs have a favorable prognosis after complete surgical resection, with no reported recurrence in these patients. Radical resection is often performed, although enucleation has recently been reported, resulting in current disease-free survival (186). Radiation, chemotherapy, and corticosteroid therapy have been implemented in patients with unresectable disease or findings of malignant pathology after resection (196)(197)(198).…”

Inflammatory myofibroblastic tumor of the pancreatic neck misdiagnosed as neuroendocrine tumor: A case report

“…It has been revealed that IMT may have gene rearrangement with anaplastic lymphoma kinase (ALK)[ 3 ], and ALK positivity was also associated with a higher recurrence and less chance of distant metastasis[ 4 ]. A recent literature review by Chen et al [ 5 ] in 2021, included 30 patients with IMT occurring in the pancreas. The reported mean age of the patients was 40 years (range, 0-82 years) with an obvious male preponderance.…”

“…In this series, abdominal pain was the most frequent symptom followed by jaundice. Only five cases of asymptomatic pancreatic IMT have been reported in the medical literature[ 5 - 9 ]. Our patient had no clinical symptoms and the pancreatic mass was found on physical examination.…”