An Inflammatory Myofibroblastic Tumor of the Ampulla of Vater Successfully Managed with Endoscopic Papillectomy: Report of a Case

Abstract

Inflammatory myofibroblastic tumors (IMTs) are solid neoplastic mesenchymal proliferations composed of myofibroblastic spindle cells admixed with inflammatory infiltrates. The documented sites in the gastrointestinal tract include the esophagus, small intestine, colon, appendix, rectum, pancreas, spleen, liver, and Meckel's diverticulum. Biliary IMTs are rare, and IMTs arising from the ampulla of Vater have not been reported previously. Herein we report the case of a 65-year-old woman with an extrahepatic biliary obstruction due to IMT of the ampulla of Vater, and a successful therapeutic approach using endoscopic ultrasonography and endoscopic papillectomy. (Gut Liver 2010;4: 419-422)

Inflammatory myofibroblastic tumor of the esophagus treated by endoscopy

“…Extrapulmonary presentation of these tumors is uncommon but has been described in such sites as the brain, trachea, breast, spleen, and the kidneys . The gastrointestinal tract can also be involved, with a variety of case reports of these masses in the liver, stomach, colon, and the Vater's ampulla . The presentation of IMT in the esophagus is extremely rare, with only a few cases described in the literature and the majority treated with a surgical approach.…”

“…18 The gastrointestinal tract can also be involved, with a variety of case reports of these masses in the liver, 19 stomach, 20 colon, 21 and the Vater's ampulla. 22 The presentation of IMT in the esophagus is extremely rare, with only a few cases described in the literature and the majority treated with a surgical approach. We report a case of a myofibroblastic tumor of the upper esophagus that was treated successfully with endoscopy.…”

A case of successful treatment of a female patient with ALK-positive inflammatory myofibroblastic tumor of the greater omentum

“…Анализ публикаций показал, что данный вид лечения применяется не более чем в 6 % случаев. Однако стоит отметить, что при консервативном лечении используются не только противоопухолевые таргетные препараты, но и нестероидные противовоспалительные препараты (НПВП) [24][25][26][27][28].…”

Inflammatory tumors of the digestive tract

“…При локализации ВМО в двенадцатиперстной кишке (ДПК), чаще выявляемой в детском возрасте, превалируют сим-птомы дуоденальной обструкции, а при локализации в большом дуоденальном сосочке (БДС) [33] или головке поджелудочной железы [34] манифестируют признаки билиарной и панкреатиче-ской гипертензии, в связи с чем ВМО не были отличимы от лока-лизованного рака головки поджелудочной железы.…”

“…Редкое наблюдение успешного лечения ВМО БДС путем эндоскопической папиллэктомии (размер опу-холи 2,5×2 см) описали J. Kwak и соавт. [33].…”