Spyrou I, Davakis S, Moris D, Lakiotaki E, Dimitrokallis N, Papalampros A, Schizas D, Pikoulis E, Felekouras E
National and Kapodistrian University of Athens , Greece.
Ann R Coll Surg Engl. 2017 May;99(5):e151-e153. doi: 10.1308/rcsann.2017.0064.
Introduction A colorectal inflammatory myofibroblastic tumour (IMT) is a rare but benign entity masquerading as a malignant tumour. Although the lung is considered the most common site of occurrence, IMTs may arise in diverse extrapulmonary locations. We describe a case of a colonic IMT in a patient who presented in the emergency setting. Case History A 77-year-old man was admitted at our emergency department with acute abdominal pain. Physical examination revealed vague tenderness of the lower abdomen and non-palpable masses. Preoperative evaluation revealed a mass in the right lower quadrant of the abdomen, possibly originating from the terminal ileum, 1-2cm from the caecum. Owing to the clinical impression of a potentially malignant lesion, the patient underwent subtotal colectomy and omentectomy. The pathology report suggested the morphological and immunohistochemical features were more compatible with a colonic IMT. Conclusions A colorectal IMT is a rare clinical entity that can easily mimic a highly malignant tumour and cannot be distinguished clinically or radiologically. An accurate diagnosis is based on histological examination and surgical resection is therefore usually required.
引言 结直肠炎性肌纤维母细胞瘤(IMT)是一种罕见的良性病变,但常伪装成恶性肿瘤。尽管肺部被认为是最常见的发病部位,但IMT也可能出现在各种肺外部位。我们描述了一例在急诊情况下就诊的结肠IMT病例。
病例史 一名77岁男性因急性腹痛入住我院急诊科。体格检查发现下腹部有模糊压痛,未触及肿块。术前评估发现腹部右下腹有一肿块,可能起源于回肠末端,距盲肠1-2厘米。由于临床怀疑为潜在恶性病变,患者接受了结肠次全切除术和网膜切除术。病理报告显示,形态学和免疫组化特征更符合结肠IMT。
结论 结直肠IMT是一种罕见的临床实体,很容易模仿高度恶性肿瘤,在临床或影像学上无法区分。准确的诊断基于组织学检查,因此通常需要手术切除。