Moges Tadesse Girma, Nureta Tilahun Habte, Mohammed Tesfaye Petros
Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Ethiopia.
Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Ethiopia.
Int J Surg Case Rep. 2023 Jul;108:108404. doi: 10.1016/j.ijscr.2023.108404. Epub 2023 Jun 15.
An inflammatory myofibroblastic tumor (IMT) is an uncommon solid neoplasm of mesenchymal origin. They are usually seen in children and adolescents and commonly affect the lung, but they can nearly arise from every organ. The prevalence of IMT in the small bowel is very rare. The tumors have generally a benign clinical course, with some risk of local recurrence or distant metastasis.
This is a 55-year-old male patient who presented with intermittent abdominal pain, vomiting of ingested matter and loss of appetite for 2 weeks duration. On physical examination, he had stable vital signs and the abdominal examination was non-revealing. Abdominal CT scan with contrast showed a long segment jejunojejunal intussusception. He underwent en-bloc resection of the mass and end-to-end anastomosis of the jejunum.
IMTs have a mesenchymal origin and are grouped into a mixture of fibroinflammatory disorders. They show a variable mix of inflammatory cells with spindle cells. The diagnosis of IMT preoperatively is challenging often mimicking malignant lesions. The diagnosis is often confirmed by histopathology after surgery. Complete excision with a negative margin is the preferred treatment. We report a rare case of jejunal IMT presenting with intussusception.
An intestinal IMT is a rare and an underdiagnosed entity, and should be considered in the differential diagnosis of small bowel intussusception. Surgery is still the most favored and effective treatment for intestinal IMT. Complete surgical excision with a negative margin has the least chance of disease recurrence.
炎性肌纤维母细胞瘤（IMT）是一种罕见的间叶源性实体肿瘤。它们通常见于儿童和青少年，常见于肺部，但几乎可起源于任何器官。IMT在小肠中的发生率非常低。这些肿瘤通常具有良性临床病程，但有一定的局部复发或远处转移风险。
这是一名55岁男性患者，出现间歇性腹痛、呕吐所摄入物质及食欲减退2周。体格检查时，生命体征平稳，腹部检查无异常发现。腹部增强CT扫描显示长段空肠-空肠套叠。他接受了肿块整块切除及空肠端端吻合术。
IMT起源于间叶组织，归类为纤维炎性疾病的一种。它们表现为炎性细胞与梭形细胞的不同混合。IMT术前诊断具有挑战性，常与恶性病变相似。诊断通常在术后通过组织病理学得以证实。切缘阴性的完整切除是首选治疗方法。我们报告了一例罕见的以套叠为表现的空肠IMT病例。
肠道IMT是一种罕见且诊断不足的疾病，在小肠套叠的鉴别诊断中应予以考虑。手术仍是肠道IMT最常用且有效的治疗方法。切缘阴性的完整手术切除疾病复发几率最低。
