J Korean Surg Soc.  2012 Jun;82(6):380-384.

A case of inflammatory myofibroblastic tumor originated from the greater omentum in young adult

Affiliations
  • 1Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea. hmcho@catholic.ac.kr
  • 2Department of Hospital Pathology, St. Vincent's Hospital, The Catholic University of Korea School of Medicine, Suwon, Korea.

Abstract

Inflammatory myofibroblastic (IMF) tumor is a rare solid tumor that often affects children. IMF tumors occur primarily in the lung, but the tumor may affect any organ system with protean manifestations. A 22-year-old woman was evaluated for palpable low abdominal mass that had been increasing in size since two months prior. Abdominal computed tomography showed a lobulated, heterogeneous contrast enhancing soft tissue mass, 6.5 x 5.7 cm in size in the ileal mesentery. At surgery, the mass originated from the greater omentum laying in the pelvic cavity and was completely excised without tumor spillage. Histologically, the mass was a spindle cell lesion with severe atypism and some mitosis. Immunohistochemistry for anaplastic lymphoma kinase-1 revealed that the lesion was an IMF tumor. Because of its local invasiveness and its tendency to recur, this tumor can be confused with a soft tissue sarcoma. Increasing physician awareness of this entity should facilitate recognition of its clinical characteristics and laboratory findings.

Keyword

Inflammatory myofibroblastic tumor; Spindle cell tumor; ALK-1; Omental mass

MeSH Terms

Child
Female
Humans
Immunohistochemistry
Lung
Lymphoma
Mesentery
Mitosis
Myofibroblasts
Omentum
Sarcoma
Young Adult

Figure

  • Fig. 1 Contrast-enhanced computed tomography scan of the abdomen in axial (A) and coronal (B). A lobulated and heterogeneous contrast enhancing soft tissue mass (arrow) originating from the ileal mesentery is seen.

  • Fig. 2 Specimen consists of a portion of tan-colored tissue, measuring 7.5 × 7.0 × 5.0 cm. Arrow indicates feeding vessel originated from greater omentum.

  • Fig. 3 Tumor shows well-circumscribed, whorled growth pattern (H&E, ×40).

  • Fig. 4 Tumor is composed predominantly of spindle or stellate-shaped cells with prominent inflammatory cells. Occasionally, ganglion-like cells (arrow) present (H&E, ×400).

  • Fig. 5 Immunohistochemical staining (×400) result for anaplastic lymphoma kinase-1 shows strong positivity of tumor cytoplasm (arrow).


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