Raza Vishal Farid, Arshad Dawood, Ahmad Sajeel, Khan Khalid Javeed
Department of General Surgery, Sir Ganga Ram Hospital, Lahore, Fatima Jinnah Medical University, Queen's Road, Lahore, 54000, Pakistan.
Ann Med Surg (Lond). 2021 Apr 22;65:102316. doi: 10.1016/j.amsu.2021.102316. eCollection 2021 May.
Inflammatory myofibroblastic tumor is a benign entity that may present as a locally aggressive malignancy, predominantly in the lung. 500 cases have been reported in the literature, and an estimated prevalence ranges from 0.04% to 0.7%.
An eighteen-year old male presented to the surgical clinic with abdominal pain. The pain was recurring despite trials of analgesics and remained undiagnosed. Radiological imaging demonstrated a lesion in the spleen. An infectious cause was presumed due to their endemicity in South Asia, however pathology showed an inflammatory myofibroblastic tumor.
Pre-operative imaging is yet to develop a set criterion that may identify this lesion, though clinicians may be clued in by the benign appearance despite the large size. Usual diagnosis is on pathology after complete surgical excision, which is the mainstay treatment advocated.
Reporting of the tumor in unusual sites such as the spleen is scarce, increase of which may help establish guidelines, understand tumor behavior and guide clinicians that may encounter it in surgical practice.
炎性肌纤维母细胞瘤是一种良性病变,可表现为具有局部侵袭性的恶性肿瘤,主要发生于肺部。文献报道了500例病例,估计患病率在0.04%至0.7%之间。
一名18岁男性因腹痛前来外科门诊就诊。尽管尝试使用了镇痛药,但疼痛仍反复出现且未得到诊断。影像学检查显示脾脏有一个病变。由于南亚地区该病的地方性流行,推测为感染性病因,但病理检查显示为炎性肌纤维母细胞瘤。
术前影像学检查尚未形成一套可识别该病变的标准,尽管病变体积较大,但外观呈良性,临床医生可能会从中得到提示。通常在完整手术切除后通过病理诊断,这是提倡的主要治疗方法。
在脾脏等不常见部位发生该肿瘤的报道较少,增加此类报道可能有助于制定指南、了解肿瘤行为并指导外科实践中可能遇到该肿瘤的临床医生。