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BMJ Case Reports 2018; doi:10.1136/bcr-2018-224549
  • Rare disease
  • CASE REPORT

Inflammatory myofibroblastic tumour: an unusual presentation including small bowel obstruction and palpable abdominal mass

  1. Mary E Dillhoff
  1. Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
  1. Correspondence to Dr Mary E Dillhoff, mary.dillhoff{at}osumc.edu
  • Accepted 7 April 2018
  • Published 15 May 2018

Summary

A 41-year-old man with no medical history presented with 2 weeks of nausea, vomiting, a new palpable abdominal mass, constipation and a 14kgweight loss. On admission, CT abdomen and pelvis demonstrated a 6.9×3.7 cm soft-tissue abdominal mass deep to and invading the lower anterior abdominal wall with tethering of the urinary bladder and potential involvement of the urachus. Subsequently, a biopsy demonstrated a low-grade spindle cell neoplasm compatible with inflammatory myofibroblastic tumour with immunostain positive for smooth muscle actin and desmin and negative for CD21, CD117, DOG-1, TKE-1, mdm2, CD34 and ALK. One week following admission, he underwent en bloc excision of the mass including abdominal wall (umbilicus, portions of rectus sheath and muscle), bladder dome, right colon and a segment of small bowel. Final pathology of the mass confirmed an inflammatory myofibroblastic tumour, and his postoperative course was uneventful.

Footnotes

  • Contributors MED cared for the patient described in the case and provided the included photographs. MED, EWB and EC prepared the case report, analysed the literature, provided critical revision and review, and approved the final version to be submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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