Inflammatory myofibroblastic tumor of the small bowel

First described in the lung, inflammatory myofibro- blastic tumors (IMT) are pseudosarcomatous lesions that occur in the viscera and soft tissue of children and young adults. Intraabdominal and retroperitoneal locations have been associated with higher degrees of cellular atypia, more aggressive clinical course, higher local recurrence and even distant metastases (1). A 23-year-old woman presented with abdominal pain, fatigue, night sweats and weight loss for six weeks. On physical examination, a large mass was palpable in the lower abdomen. MRI con- firmed the presence of a 7 × 8 × 9 cm solid lesion involv- ing the small bowel (Figs. 1 and 2). A Pfannenstiel lapa- rotomy was performed and a tumor was found arising from the mesenteric border of the terminal ileum. The tumor was completely resected with primary ileo-caecal anastomosis. Histopathology revealed an inflammatory myofibroblastic tumor (IMT) with proliferation of spin- dle-shaped cells in fascicular growth patterns and lym- phocytic inflammatory infiltrate. Immunohistochemistry was highly positive in tumor cells for actin alpha (Figs. 3a and 3b). Postoperative recovery was uncomplicated and the patient left hospital five days after surgery.