Huge pelvi-abdominal malignant inflammatory myofibroblastic tumor

Inflammatory myofibroblastic tumor (IMT) is an uncommon benign neoplasm with locally aggressive behavior but malignant change is rare. Such a rare tumor occurring in a 14-year-old patient with clinical presentations of abdominal pain and body weight loss was seldom described before.

A research article to be published on June 7, 2010 in the World Journal of Gastroenterology addresses this question. A research team led by Professor Ko from Chang Gung University College of Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Taiwan, reported that computed tomography was useful for clear delineation of this huge pelvic-abdominal mass with extraperitoneal origin and prominent peritumoral vascularity which was crucial for surgical planning. Subsequent surgery, histopathology, immunohistochemistry, DNA sequencing and electron microscopy confirmed the final diagnosis of inflammatory myofibroblastic tumor with malignant transformation. Despite radical tumor resection, rapid tumor recurrence occurred in the lower abdomen 20 d after discharge.

This report documents the first known case of pelvic extraperitoneal IMT with malignant transformation in a pediatric patient. In light of this case, IMT should be considered in the differential diagnosis of pelvi-abdominal mass with large central necrosis and the presence of prominent peritumoral vascularity may also be a clue of high metabolic demand and even malignant transformation.

Reference: Lu CH, Huang HY, Chen HK, Chuang JH, Ng SH, Ko SF. Huge pelvi-abdominal malignant inflammatory myofibroblastic tumor with rapid recurrence in a 14-year-old boy. World J Gastroenterol 2010; 16(21): 2698-2701 http://www.wjgnet.com/1007-9327/full/v16/i21/2698.htm

Correspondence to: Sheung-Fat Ko, MD, Department of Radiology, Chang Gung Memorial Hospital- Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien, 833, Taiwan, China. sfa.ko@msa.hinet.net Telephone: +886-7-7317123 Fax: +886-7-7318762

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.