Esophageal Inflammatory Pseudotumor Mimicking Malignancy.

Abstract

A 54-year-old man with a complaint of dysphagia was found to have a prominent stricture in the proximal esophagus. A biopsy of the stenotic area indicated sarcoma, leading to subtotal esophagectomy. The surgically removed esophagus demonstrated a well-defined intramural mass, consisting of a mixture of fibroblastic cells with bland cytological appearances and inflammatory cells. Reflux esophagitis which was present distal to the stricture seemed to play a role in the development of this inflammatory pseudotumor.

Inflammatory Pseudotumor of the Esophagus—GI Image

“…IMT exhibits immunopositivity for vimentin, partly for desmin, actin, and cytokeratin and immunonegativity for S-100, CD34, CD117, and CD68. 1,7,8 The most commonly reported primary therapy is surgical resection (i.e., enucleation and partial or total esophagectomy). 7-10 The use of enucleation versus esophagectomy must be balanced between the recurrence risk and operative morbidity.…”

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

“…8 In the gastrointestinal tract, the documented sites include esophagus, small intestine, colon, appendix, rectum, pancreases, spleen, liver, or a Meckel's diverticulum. [9][10][11] Especially in bilopancreati tract, most IMTs have been reported in pancreas 12,13 but the biliary IMT is even rarer. 14 Because pancreatic IMT was commonly mistaken for a pancreatic cancer clinically and radiologically, surgical resection was usually known as effective treatment.…”

Inflammatory Myofibroblastic Tumor of the Midesophagus

“…Recurrence after complete resection is rare. These lesions are often misdiagnosed as sarcomas [3], An accurate diagnosis can only be made following surgical excision, and hyperdiploidy is associated with a more aggressive clinical picture and a higher rate of progression to sarcoma if there is recurrence [4,6,7].…”