Korean J Gastroenterol.  2018 Jul;72(1):28-32. 10.4166/kjg.2018.72.1.28.

Case of an Inflammatory Myofibroblastic Tumor of the Duodenum

• Park SG
• Kim GH
• Park HJ
• Kahng DH
• Lee BE
• Park DY

• KMID: 2416933
• DOI: http://doi.org/10.4166/kjg.2018.72.1.28

Abstract

An inflammatory myofibroblastic tumor (IMT) is a rare disease that can occur in a variety of locations, including the lung, orbit, parotid, pleura, and stomach. Despite multiple reports in various organs, a duodenal IMT is rare with limited case reports. We encountered a case of a 49-year-old male with a duodenal IMT. The patient underwent a laparoscopic wedge resection under the impression of a duodenal mesenchymal tumor, such as gastrointestinal stromal tumor, but the final diagnosis was a duodenal IMT. The patient was treated successfully with an oral nonsteroidal anti-inflammatory drug for the residual lesions. He was free of recurrence during the 12 month follow-up period.

Keyword

Duodenum; Inflammatory myofibroblastic tumor; Gastrointestinal stromal tumors

MeSH Terms

Diagnosis
Duodenum*
Follow-Up Studies
Gastrointestinal Stromal Tumors
Humans
Lung
Male
Middle Aged
Myofibroblasts*
Orbit
Pleura
Rare Diseases
Recurrence
Stomach

Figure

• 

  Fig. 1. (A) Endoscopic finding. Endoscopy reveals a 2-cm-sized subepithelial tumor with central ulcer in the second portion of the duodenum.(B) Endoscopic ultrasonography. On endoscopic ultrasonography, the tumor is a heterogeneous hypoechoic mass with unclear border, originating from the deep mucosal and submucosal layers.

• 

  Fig. 2. Abdominal computed tomography (CT) reveals a 1.7-cm-sized hypervascular solid mass in the second portion of the duodenum (red arrows). (A) CT transverse view. (B) CT coronal view.

• 

  Fig. 3. (A) Gross finding. Resected specimen shows a relatively well-defined, yellowing subepithelial mass. (B) Microscopic finding reveals spindle cell tumors (red arrows), scattered inflammatory cells (blue arrows), epithelial cells (yellow arrows), and stellate cells (green arrow)(H&E,×400). (C-F) Immunohistochemical stain. Positive for SMA (C, ×400), and negative for S-100 (D, ×100), C-kit (E, ×400), ALK (F, ×200). SMA, smooth muscle actin; ALK, anaplastic lymphoma kinase.

Reference

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