Case Report
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World J Gastroenterol. Oct 7, 2014; 20(37): 13625-13631
Published online Oct 7, 2014. doi: 10.3748/wjg.v20.i37.13625
Intra-abdominal inflammatory myofibroblastic tumor: Spontaneous regression
Jun-Jie Zhao, Jia-Qian Ling, Yong Fang, Xiao-Dong Gao, Ping Shu, Kun-Tang Shen, Jing Qin, Yi-Hong Sun, Xin-Yu Qin
Jun-Jie Zhao, Jia-Qian Ling, Yong Fang, Xiao-Dong Gao, Ping Shu, Kun-Tang Shen, Jing Qin, Yi-Hong Sun, Xin-Yu Qin, Department of General Surgery, Zhong Shan Hospital, Fudan University, Shanghai 200032, China
Author contributions: Zhao JJ and Ling JQ contributed equally to this work; Zhao JJ, Ling JQ, Shen KT, Qin J, Sun YH and Qin XY treated the two patients; Fang Y, Gao XD and Shu P collected the clinical data; Zhao JJ and Ling JQ reviewed the published articles and analyzed data; Zhao JJ and Ling JQ wrote the paper; and Shen KT critically revised the paper with important conceptual and editorial input.
Correspondence to: Kun-Tang Shen, MD, Professor, Department of General Surgery, Zhong Shan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai 200032, China. shen.kuntang@zs-hospital.sh.cn
Telephone: +86-21-64038472 Fax: +86-21-64038472
Received: January 16, 2014
Revised: April 1, 2014
Accepted: May 29, 2014
Published online: October 7, 2014
Processing time: 263 Days and 20.5 Hours
Abstract

Inflammatory myofibroblastic tumors are usually treated by surgical resection. We herein report two cases of intra-abdominal inflammatory myofibroblastic tumors that were unresectable and underwent spontaneous regression without any treatment. Our case report and literature review show that regression is more common in the middle-aged and older male populations. Abdominal discomfort and fever were the most common symptoms, but the majority of patients had no obvious physical signs. There was no specific indicator for diagnosis. The majority of the lesions regressed within 3 mo and nearly all of the masses completely resolved within 1 year. We conclude that the clinical characteristics of inflammatory myofibroblastic tumors are variable and, accordingly, the disease needs to be subdivided and treated on an individual basis. Surgery is always the first-line treatment; however, for those masses assessed as unresectable, conservative therapy with intense follow-up should be considered.

Keywords: Inflammatory myofibroblastic tumor; Inflammatory pseudotumor; Abdominal cavity; Spontaneous regression

Core tip: This article reports two rare cases involving the spontaneous regression of an unresectable intra-abdominal inflammatory myofibroblastic tumor (IMT) and summarizes the clinical characteristics of all published cases. The clinical characteristics of IMT are not clear and the treatment is controversial. By analyzing published papers, we discovered some common features of the disease and potential reasons for this unusual phenomenon. Our findings may be useful for the clinical diagnosis and treatment of IMT.