Inflammatory myofibroblastic tumor successfully treated with chemotherapy and nonsteroidals: A case report

Abstract

Inflammatory myofibroblastic tumor (IMT) occurring at retroperitoneal sites has rarely been reported. We report the case of a previously well 14-year-old girl with no history of abdominal disease whose past medical history and family tumor history were unremarkable. She complained of intermittent abdominal pain for one month. An abdominal mass was found on physical examination and abdominal contrast-enhanced computed tomography (CT) showed a hypodense soft mass, the size and location of which suggested a well delineated retroperitoneal tumor surrounding the superior mesenteric vessels measuring 3.3 cm × 4.5 cm × 4.5 cm with enlarged lymph nodes. The patient underwent an exploratory laparotomy followed by biopsy and was subsequently diagnosed with retroperitoneal IMT. She was successfully treated with postoperative chemotherapy and oral diclofenac sodium. Following completion of therapy the mass was no longer palpable and no longer visible on CT scanning. The use of methotrexate and cisplatin for aggressive myofibroblastic tumors is also reviewed.

Inflammatory myofibroblastic tumour: an unusual presentation including small bowel obstruction and palpable abdominal mass

“…Another report describes a mesenteric IMT in a young adult who presented with abdominal pain, weight loss and paraumbilical palpable mass who was treated with complete surgical resection 14. An additional report describes an adult man with a mesenteric IMT who presented with abdominal pain and weakness and was treated with complete surgical resection without recurrence 4. All reports agree that the primary treatment for IMT is complete surgical resection and highlight the importance of close, long-term follow-up to detect local recurrence 4 13 14…”

Inflammatory tumors of the digestive tract

“…Y. Tao и соавт. [45] при не-резектабельной забрюшинной ВМО успешно применили комби-нацию полихимиотерапиии (ПХТ) (метотрексат/цисплатин) в средних дозах с пероральным приемом нестероидных противо-воспалительных препаратов (НПВП). Период безрецидивного незавершенного наблюдения составил более 3 лет.…”

Recurrent retroperitoneal inflammatory myofibroblastic tumor: A case report

“…Tao et al (9) reported an unresectable retroperitoneal IMT, which was successfully treated with methotrexate, cisplatin and diclofenac sodium, facilitating maintenance of a clinical 'free of disease' status for 3 years. Przkora et al (4) also reported a case of unreseactable IMT, treated with anti-inflammatory agent, ibuprofen, where the patient was 'stabilized' for 12 months.…”

“…The role of radiotherapy in IMT is unknown, although it may have potential benefits, particularly in unresectable cases. To date, there is no established protocol for the treatment of IMT, due to its rarity (9,15).…”

“…Compared with other extra-pulmonary lesions, retroperitoneal IMTs tend to be more aggressive. Of the 12 reported cases in the English literature, summarized in Table I, 3 cases developed metastases and one exhibited local recurrence, with follow-up periods varying from 3 to 80 months (2)(3)(4)(5)(6)(7)(8)(9)(10).…”