Inflammatory myofibroblastic tumors of the duodenum

Abstract

Inflammatory myofibroblastic tumors (IMTs) are rare soft-tissue tumors that can occur at virtually any anatomical site. We report the case of a 58-year-old male with an IMT of the fourth part of the duodenum who presented with signs and symptoms of high intestinal obstruction and bilious vomiting. The patient underwent a surgical resection of the fourth part of the duodenum with end-to-end duodenojejunal anastomosis. The follow-up period of 6 months was uneventful with no evidence of recurrence. According to our knowledge, only six cases of duodenal IMTs have been reported in the literature thus far, and this is the first report of a duodenal IMT sited at the fourth part of the duodenum. The duodenum is among the rarest sites of IMTs. Signs and symptoms resulting from diagnostic imaging investigations are nonspecific and inadequate to obtain diagnosis accurately. In most cases, surgical treatment is considered a cure for IMTs. There is no evidence of deaths caused by duodenal IMT. IMT of the duodenum is a possible diagnosis in differential diagnosis of tumor-like lesions of the duodenum.

Inflammatory myofibroblastic tumor presenting as ileocecal intussusception—A case report

“…IMFTs were first well described in the lungs and later became recognized in extrapulmonary locations [2] , [3] , [4] , [5] − 43% of extra-pulmonary involvement affects the mesentery and omentum [7] . Gastrointestinal (GI) involvement is rare however there are reports of involvement of any part of GI tract [2] , [6] , [7] , [8] , [9] . It occurs mostly in childhood and young adults but patients of any age and sex can be affected [2] .…”

“…A constitutional syndrome consisting of fever, weight loss and malaise is seen in 15–30% of patients [3] . IMFT derived from the GI tract presents with clinical symptoms of anemia, loss of appetite or weight, fecal blood positive [2] , abdominal pain, GI obstruction [9] , or intussusception [10] . Our patient presented with 2 months history of abdominal pain and unintentional weight loss of 8 kg, and imaging techniques revealed it to be an ileocecal intussusception.…”

Inflammatory Pseudotumor (IPT) and Inflammatory Myofibroblastic Tumor (IMT): A Representative Literature Review Occasioned by a Rare IMT of the Transverse Colon in a 9-year-old Child

“…Most IPT/IMTs of the gastrointestinal tract are treated surgically or resected endoscopically (2, 8, 11, 17, 52, 53). Surgery is also indicated in cases of acute intestinal obstruction (52, 54, 55).…”

“…Clinical symptoms are nonspecific, such as nausea, vomiting, anorexia, pain, fever, chills, night sweats, weight loss, and anemia (1, 2, 7–10, 29, 31), or organotypic and site-specific, e.g., dysphagia, gastrointestinal bleeding, obstruction symptoms, especially including intestinal invagination, and icterus (1, 7, 8, 11, 22, 26, 33, 53–55).…”

“…Petrovic et al (11) mentioned reports on 7 cases of the duodenum, including a case of their own, 2 female and 5 male, with an average age of 26 years.…”