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. 2016:24:146-9.
doi: 10.1016/j.ijscr.2016.05.027. Epub 2016 May 19.

Inflammatory myofibroblastic tumor presenting as ileocecal intussusception-A case report

Cláudia Paiva  1 , Filomena Soares  2 , Raquel da Inez Correia  3 , Vítor Valente  4
Affiliations

Inflammatory myofibroblastic tumor presenting as ileocecal intussusception-A case report

Cláudia Paiva et al. Int J Surg Case Rep. 2016.

Abstract

Introduction: Inflammatory myofibroblastic tumor (IMFT) is an uncommon mesenchymal solid tumor commonly documented in children and young adults. It is usually located in lungs however, extrapulmonary involvement has also been reported. Here we report a case of IMFT presenting as an ileocecal intussusception.

Presentation of case: A 55-year-old man presented with a two months history of colicky abdominal pain, more intense at the right inferior abdominal quadrant, and unintentional weight loss of 8kg in the previous four months. Computer tomography showed an image of intussusception at the cecum. Colonoscopy demonstrated a pediculated tubular lesion, with the base near ileocecal valve. We performed a right hemicolectomy. Histopathological examination of the tumor revealed an IMFT.

Discussion: IMFT usually affects lungs with rare gastrointestinal involvement. Clinical presentation is related with location of the neoplasm. Intussusception in adults presents with non-specific symptoms and classical image signs facilitate preoperative diagnosis. IMFT diagnosis is histopathological which usually implies surgical resection. Complete surgical excision, with microscopically clear margins, is the mainstain of treatment, with virtually no local recurrence or metastasis.

Conclusion: Gastrointestinal IMFT are rare in the adult population and clinical features depend on its location. Surgical approach with total excision of the neoplasm confirms the diagnosis. Prognosis is good with the main prognostic indicator being the adequacy of the primary excision.

Keywords: Adult; Case report; Ileocecal intussusception; Inflammatory myofibroblastic tumor.

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Figures

Fig 1
Fig 1
Ultrasonographic image in transverse section: hypoechoic outer layer of edematous bowel wall with echogenic layers, known as the “bulls-eye” or “target” signs, which are characteristic images in intussusception.
Fig. 2
Fig. 2
Axial CT of the abdomen: shows the edematous wall of the intussuscipiens, the “target” sign, suggesting ileocecal intussusception.
Fig. 3
Fig. 3
Endoscopic examination revealed a pediculated lesion, with the base near ileocecal valve, occupying most of ascending colic lumen.
Fig. 4
Fig. 4
Bowel wall is cut away, revealing the mass emanating near the base of the appendix.
See this image and copyright information in PMC

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