A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery
Abstract Background An Inflammatory myofibroblastic tumor (IMT) is a rare intermediate malignancy characterized by myofibroblast proliferation and inflammatory cell infiltration. Various organs are the primary sites of origin. However, primary tumors originating in the stomach tend to be extremely r...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Japan Surgical Society
2023-10-01
|
| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40792-023-01767-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849428529758863360 |
|---|---|
| author | Naoya Kimura Masatsugu Hiraki Michiaki Akashi Koichi Miyahara Minori Imamura Shunsuke Furukawa Ryuichiro Samejima |
| author_facet | Naoya Kimura Masatsugu Hiraki Michiaki Akashi Koichi Miyahara Minori Imamura Shunsuke Furukawa Ryuichiro Samejima |
| author_sort | Naoya Kimura |
| collection | DOAJ |
| description | Abstract Background An Inflammatory myofibroblastic tumor (IMT) is a rare intermediate malignancy characterized by myofibroblast proliferation and inflammatory cell infiltration. Various organs are the primary sites of origin. However, primary tumors originating in the stomach tend to be extremely rare, making the diagnosis difficult. Herein, we present a case of IMT originating in the stomach that was effectively managed using inverted laparoscopic endoscopic cooperative surgery (LECS). Case presentation A 47-year-old male who was admitted to the hospital because of a submucosal tumor that was discovered during upper gastrointestinal endoscopy. The diameter of the tumor was approximately 20 mm. A KIT-negative gastrointestinal stromal tumor was suspected based on the biopsy findings. Therefore, partial resection of the stomach was performed using inverted laparoscopic and endoscopic cooperative surgery. Histopathological examination revealed collagen fiber proliferation from the submucosal layer to the muscular layer, accompanied by infiltration of spindle-shaped cells, lymphocytes, and numerous inflammatory cells. Immunohistochemistry results were positive for SMA and negative for CD34, desmin, and c-kit. IgG4-positive cells were observed with an IgG4/IgG ratio > 50%, and specific nuclei were positive for ALK. Therefore, IMT was diagnosed. This condition may be difficult to diagnose both before and after surgery because of its rarity and submucosal tumor-like morphology. Conclusion When a submucosal tumor originating in the stomach is observed, IMT should be considered. Partial resection of the stomach with LECS and immunohistochemical diagnosis may be useful. |
| format | Article |
| id | doaj-art-276ba8e825f845f2b5bcce47a49ed39b |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2023-10-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-276ba8e825f845f2b5bcce47a49ed39b2025-08-20T03:28:41ZengJapan Surgical SocietySurgical Case Reports2198-77932023-10-01911910.1186/s40792-023-01767-9A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgeryNaoya Kimura0Masatsugu Hiraki1Michiaki Akashi2Koichi Miyahara3Minori Imamura4Shunsuke Furukawa5Ryuichiro Samejima6Department of Surgery, Japan Red Cross Society Karatsu Red Cross HospitalDepartment of Surgery, Japan Red Cross Society Karatsu Red Cross HospitalDepartment of Pathology, Japan Red Cross Society Karatsu Red Cross HospitalDepartment of Internal Medicine, Japan Red Cross Society Karatsu Red Cross HospitalDepartment of Surgery, Japan Red Cross Society Karatsu Red Cross HospitalDepartment of Surgery, Japan Red Cross Society Karatsu Red Cross HospitalDepartment of Surgery, Japan Red Cross Society Karatsu Red Cross HospitalAbstract Background An Inflammatory myofibroblastic tumor (IMT) is a rare intermediate malignancy characterized by myofibroblast proliferation and inflammatory cell infiltration. Various organs are the primary sites of origin. However, primary tumors originating in the stomach tend to be extremely rare, making the diagnosis difficult. Herein, we present a case of IMT originating in the stomach that was effectively managed using inverted laparoscopic endoscopic cooperative surgery (LECS). Case presentation A 47-year-old male who was admitted to the hospital because of a submucosal tumor that was discovered during upper gastrointestinal endoscopy. The diameter of the tumor was approximately 20 mm. A KIT-negative gastrointestinal stromal tumor was suspected based on the biopsy findings. Therefore, partial resection of the stomach was performed using inverted laparoscopic and endoscopic cooperative surgery. Histopathological examination revealed collagen fiber proliferation from the submucosal layer to the muscular layer, accompanied by infiltration of spindle-shaped cells, lymphocytes, and numerous inflammatory cells. Immunohistochemistry results were positive for SMA and negative for CD34, desmin, and c-kit. IgG4-positive cells were observed with an IgG4/IgG ratio > 50%, and specific nuclei were positive for ALK. Therefore, IMT was diagnosed. This condition may be difficult to diagnose both before and after surgery because of its rarity and submucosal tumor-like morphology. Conclusion When a submucosal tumor originating in the stomach is observed, IMT should be considered. Partial resection of the stomach with LECS and immunohistochemical diagnosis may be useful.https://doi.org/10.1186/s40792-023-01767-9Inflammatory myofibroblast tumorStomachSubmucosal tumorLaparoscopic and endoscopic cooperative surgery |
| spellingShingle | Naoya Kimura Masatsugu Hiraki Michiaki Akashi Koichi Miyahara Minori Imamura Shunsuke Furukawa Ryuichiro Samejima A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery Surgical Case Reports Inflammatory myofibroblast tumor Stomach Submucosal tumor Laparoscopic and endoscopic cooperative surgery |
| title | A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery |
| title_full | A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery |
| title_fullStr | A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery |
| title_full_unstemmed | A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery |
| title_short | A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery |
| title_sort | rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery |
| topic | Inflammatory myofibroblast tumor Stomach Submucosal tumor Laparoscopic and endoscopic cooperative surgery |
| url | https://doi.org/10.1186/s40792-023-01767-9 |
| work_keys_str_mv | AT naoyakimura ararecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT masatsuguhiraki ararecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT michiakiakashi ararecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT koichimiyahara ararecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT minoriimamura ararecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT shunsukefurukawa ararecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT ryuichirosamejima ararecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT naoyakimura rarecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT masatsuguhiraki rarecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT michiakiakashi rarecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT koichimiyahara rarecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT minoriimamura rarecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT shunsukefurukawa rarecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery AT ryuichirosamejima rarecaseofinflammatorymyofibroblasttumorofthestomachsuccessfullytreatedbyinvertedlaparoscopicandendoscopiccooperativesurgery |