Inflammatory Myofibroblastic Tumor of Sigmoid Colon: Unusual Cause of Intestinal Obstruction

Abstract

Inflammatory myofibroblastic tumors (IMFTs) are rare solid mesenchymal tumors frequently noted in children and young adults. It is characterized by variable clinicopathological and etiopathogenetic features. They are commonly reported in the lungs and occurrence in the colon is extremely rare. Here, we report a case of IMFT in the sigmoid colon confirmed histopathologically after surgical resection. A 40-year-old lady presented with abdominal pain, vomiting, and constipation for four days. On abdominal examination, there was tenderness in the left iliac fossa region with localized guarding. Contrast-enhanced computed tomography (CECT) showed a sigmoid colonic mass lesion with few enlarged perilesional lymph nodes. Colonoscopy demonstrated circumferential ulceration with irregular margin associated with luminal narrowing noted 55 cm from the anal verge and scope could not negotiate beyond, biopsies were taken. Later, the biopsy came as descriptive in nature. Hence, we proceeded for surgery and intra-operatively we have found there was circumferential thickening in the sigmoid colon for about size 8 cm of which was abutting the left lateral parietal wall. We have done sigmoid colon resection with adequate margins and postoperatively patient did well. Finally, the histopathology report suggested an IMFT sigmoid colon.

Huge mesenteric inflammatory myofibroblastic tumor as a rare cause of intussusception with recurrence after 10 months: Case report and literature review

“…Distant metastasis is infrequent and is often connected to the absence of anaplastic lymphoma kinase (ALK) reactivity. Employing serial radiological assessments and measurements of erythrocyte sedimentation rate (ESR) can aid in detecting early recurrence [ 8 , 17 ].…”

“…Various treatment methods have been documented for IMT, with surgery being the preferred approach. Complete surgical removal with an adequate negative margin carries a recurrence rate of less than 10 % [ 8 ]. Currently, the regular utilization of chemoradiation for managing IMT is not supported by available evidence.…”

“…However, radiotherapy might be employed for cases involving inoperable tumors, incomplete resection, or recurrence after surgery. Additionally, chemotherapy in conjunction with oral non-steroidal anti-inflammatory drugs could serve as a therapeutic possibility for unresectable tumors [ 8 ]. A thorough long-term follow-up is necessary to establish definitive recommendations regarding effective treatments for local recurrence and metastasis.…”

“…Consequently, the utilization of chemoradiation treatment is restricted to specific situations, including inoperable tumors, incomplete resection, and the presence of positive margins after resection. Chemotherapy and oral nonsteroidal anti-inflammatory drugs could be contemplated as therapeutic alternatives in cases involving unresectable tumors [ 8 ].…”

An inflammatory myofibroblastic tumor of the small intestine presenting as jejunojejunal intussusception; A case report

“…So, the use of chemoradiation treatment is limited to the following conditions, such as inoperable tumors, incomplete resection, and positive margins after resection. Chemotherapy and oral non-steroidal anti-inflammatory drugs may be considered therapeutic options in unresectable tumors [ 4 ].…”