Liang Wenjie, Lin Shengzhang, Chen Zhihua
Department of Radiology Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University.79# Qingchun Road, Hangzhou City, Zhejiang Province Department of General Surgery, the First People's Hospital of Taicang City, Taicang Affiliated Hospital of Soochow University, Taicang, Suzhou, China.
Medicine (Baltimore). 2017 Oct;96(41):e8297. doi: 10.1097/MD.0000000000008297.
Inflammatory myofibroblastic tumors (IMTs) are rare neoplastic lesions with benign tendency. Even more rare are IMTs from the greater omentum (GO-IMT). A GO-IMT is easily misdiagnosed as other malignant tumors before operation; thus, clinicians need to be familiar with its imaging findings. Here, we report the imaging findings of a GO-IMT patient presenting with a pelvic mass.
Ultrasound of the IMT in the pelvic cavity showed a hypoechoic mass. A computed tomography (CT) scan showed a nearly circular soft tissue mass with a clear border and heterogeneous density, and the surrounding tissues were pushed and compressed. Contrast-enhanced CT showed severe persistent enhancement in the lesion edges and mural nodules, but not in the central necrosis.
Histopathology and immunohistochemistry confirmed that the mass was a GO-IMT.
The tumor was resected after preoperative preparation.
No recurrence or metastasis was found during a short-term follow-up.
The GO-IMT is an inferior epigastric mass in the periphery of the bowel, and is usually well-demarcated without calcification or lymphadenopathy. Contrast-enhanced CT showed a heterogeneous hypervascular mass where the center necrosis, the edge of the tumor, and the mural nodules can be partially reinforced.
炎性肌纤维母细胞瘤(IMT)是一种具有良性倾向的罕见肿瘤性病变。来自大网膜的IMT(GO-IMT)更为罕见。GO-IMT在术前很容易被误诊为其他恶性肿瘤;因此,临床医生需要熟悉其影像学表现。在此,我们报告一例表现为盆腔肿块的GO-IMT患者的影像学表现。
盆腔内IMT的超声检查显示为低回声肿块。计算机断层扫描(CT)显示一个边界清晰、密度不均匀的近圆形软组织肿块,周围组织被推压和压缩。增强CT显示病变边缘和壁结节有明显的持续强化,但中央坏死区无强化。
组织病理学和免疫组织化学证实该肿块为GO-IMT。
术前准备后切除肿瘤。
短期随访期间未发现复发或转移。
GO-IMT是位于肠管周围的下腹部肿块,通常边界清晰,无钙化或淋巴结肿大。增强CT显示为不均匀的高血供肿块,中央坏死,肿瘤边缘和壁结节可部分强化。