Taiymi Afafe, Meryem Nasiri, Bouziane Mohammed, Zazour Abdelkrim, Kharrasse Ghizlane, Khannoussi Wafaa, Ismaili Zahi
Gastroenterology and Hepatology, Digestive Disease Research Laboratory, Mohammed First University, Oujda, MAR.
Gastroenterology and Hepatology, Mohammed VI University Hospital, Oujda, MAR.
Cureus. 2023 Jun 30;15(6):e41213. doi: 10.7759/cureus.41213. eCollection 2023 Jun.
An abdominal inflammatory myofibroblastic tumor (AIMT), is a rare benign tumor composed of inflammatory and other mesenchymal cells. It can affect the entire body, predominantly in children and young adults. The diagnosis is challenging considering the wide clinical presentation and can often be mistaken for malignant tumors. We report a rare case of a 46-year-old female patient, who presented with intermittent abdominal pain weight loss, and an abdominal palpable mass. Abdominal ultrasound found a well-defined 18 cm, rounded mass, with solid and cystic components. Abdominal CT demonstrated a well-defined, hypodense, retro gastric mass of 20 cm, with thickened wall and heterogenous enhancement. The mass had contact with the pancreatic tail, transverse colon, spleen, left kidney pedicles, abdominal aorta, superior mesenteric vein, and mesaraic trunk with no invasion signs. The mass was initially thought to be pancreatic cancer, but given the large size, other diagnoses like sarcoma, lymphoma, or abdominal hydatid cyst were suggested. Endoscopic ultrasound found a rounded retro gastric mass of 18/12 cm, with a thickened wall and well-limited calcifications. The content was both cystic and solid with mobile vegetations, with no visible Doppler flow. The mass had contact with the body and tail of the pancreas, spleen hilum, the upper pole of the spleen, and the hepatic pedicle behind, with no invasion sign. After a multidisciplinary team meeting, a decision was taken to perform surgical resection with mass resection, distal splenopancreatectomy, and transverse and sigmoid colectomy. Pathological and immunostaining results were consistent with inflammatory pseudotumor. The postoperative recovery was uncomplicated. The patient remains asymptomatic with no obvious signs of metastasis or recurrence. AIMT represents a reel diagnostic challenge. Clinical symptoms are unspecific. Radiological and endoscopic features can often be mistaken for malignant tumors. Surgical management remains to be the best therapeutic option. We report a rare case of AIMT treated by surgery with complete resection. We suggested a long-term follow-up given the local recurrence risk.
腹部炎性肌纤维母细胞瘤（AIMT）是一种由炎性细胞和其他间充质细胞组成的罕见良性肿瘤。它可累及全身，主要发生于儿童和年轻人。鉴于临床表现多样，其诊断具有挑战性，且常被误诊为恶性肿瘤。我们报告一例罕见的46岁女性患者，她出现间歇性腹痛、体重减轻以及腹部可触及肿块。腹部超声发现一个边界清晰的18厘米圆形肿块，有实性和囊性成分。腹部CT显示一个边界清晰、低密度的20厘米胃后肿块，壁增厚且强化不均匀。该肿块与胰尾、横结肠、脾脏、左肾蒂、腹主动脉、肠系膜上静脉和肠系膜干有接触，但无侵犯迹象。该肿块最初被认为是胰腺癌，但鉴于其体积较大，也有人提出其他诊断，如肉瘤、淋巴瘤或腹部包虫囊肿。内镜超声发现一个18/12厘米的圆形胃后肿块，壁增厚且钙化界限清晰。内容物既有囊性又有实性，有可移动的赘生物，未见明显多普勒血流信号。该肿块与胰腺体尾部、脾门、脾上极以及后方的肝蒂有接触，无侵犯迹象。经过多学科团队会诊，决定进行手术切除，包括肿块切除、远端脾胰切除术以及横结肠和乙状结肠切除术。病理和免疫染色结果与炎性假瘤一致。术后恢复顺利。患者无症状，无明显转移或复发迹象。AIMT是一个真正的诊断难题。临床症状不具特异性。放射学和内镜特征常被误诊为恶性肿瘤。手术治疗仍是最佳治疗选择。我们报告一例罕见的通过手术完全切除治疗的AIMT病例。鉴于存在局部复发风险，我们建议进行长期随访。
