Fever of Unknown Origin as a Presentation of Gastric Inflammatory Myofibroblastic Tumor in a Two-Year-Old Boy

Abstract

Gastric inflammatory myofibroblastic tumor (IMT) is an extremely rare lesion with mimicking malignant features and accompanied with various clinical manifestations. Here we present a 2-yr-old boy who had a gastric IMT with a huge extragastric mass, which closely resembled a neuroblastoma on imaging studies. He experienced intermittent fever and poor appetite for 6 weeks. Fever remained up to 38°C even on the operation day. He underwent partial gastrectomy and distal pancreatectomy with splenectomy including the tumor. The preoperative fever disappeared and did not recur in the postoperative course.

Inflammatory myofibroblastic tumor of the stomach presenting as an exophytic mass - a diagnostic dilemma

“…They may undergo spontaneous regression (8). Gastric IMTs have relatively good prognosis as the recurrence rate is 15% to 37% within a year after surgery (7). Complete surgical excision is the treatment of choice with long-term follow-up (2,4,9).…”

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.…”

Inflammatory myofibroblastic tumor arising from the ascending aorta mimicking a thymoma

“…The clinical symptoms of an IMT can vary depending on the infiltrated organ and mass effect. In 15-30% of the patients, general inflammatory symptoms, including fever, weight loss, and malaise, are commonly observed; however, asymptomatic development of the mass is also a distinct possibility [1,4]. Cantera et al reported that IMTs are often suspected to be malignant neoplasms, based on radiologic features, while they are not in reality.…”