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Kourti A, Dimopoulou A, Zavras N, Sakellariou S, Palamaris K, Kanavaki I, Fessatou S. Inflammatory fibroid polyp of the anus in a 12-month-old girl: Case report and review of the literature. J Paediatr Child Health 2022; 58:1313-1316. [PMID: 35730111 DOI: 10.1111/jpc.16080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/13/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022]
Abstract
Inflammatory fibroid polyp (IFP) is a rare, usually solitary and intraluminal polypoid benign tumour that can affect any part of the gastrointestinal (GI) tract. Its aetiology is unknown and clinical presentation depends on the site of involvement. We present the case of a 12-month-old girl with IFP and review all reported cases of IFP in children and adolescents <18 years. A 12-month-old girl presented with rectal bleeding. The patient underwent colonoscopy which revealed an anus polyp. Surgical resection was performed and histopathological examination of the specimen showed features of IFP. A literature review of 20 cases (including ours) between 1966 and January 2022 is also presented. To our knowledge, this is the youngest reported patient with IFP and the first in the anal area.
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Affiliation(s)
- Afroditi Kourti
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Third Department of Paediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Dimopoulou
- Department of Pediatric Surgery, Attikon University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Zavras
- Department of Pediatric Surgery, Attikon University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Stratigoula Sakellariou
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kostas Palamaris
- First Department of Pathology, Medical School, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ino Kanavaki
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Third Department of Paediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Smaragdi Fessatou
- Department of Paediatric Gastroenterology, Hepatology and Nutrition, Third Department of Paediatrics, Attikon University General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Calderon MG, Caivano VC, Bagnaresi S, de Oliveira Lira JO, Raimundo RD, de Abreu LC, Correa JA. A unique case of inflammatory fibroid polyp in the duodenum of a female adolescent: Case report and literature review. Medicine (Baltimore) 2017; 96:e6131. [PMID: 28225494 PMCID: PMC5569430 DOI: 10.1097/md.0000000000006131] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Inflammatory fibroid polyp (IFP) is a very rare benign condition in children that can occur throughout the gastrointestinal tract. It is characterized as a polypoid lesion originating in the submucosa, composed of connective tissue and eosinophilic infiltrate. It is most common in the stomach and in adults between the fifth and seventh decades of life. Its occurrence is unusual in the duodenum. CASE SUMMARY One case of duodenal IFP was described and the literature is reviewed with emphasis on the clinical and pathological features of IFP in children. A case of an IFP in the duodenum of a 13-year-old girl, who presented with abdominal pain, weight loss, vomiting, and constipation. The patient underwent exploratory laparotomy; a stenosing tumor of the third duodenal portion was found. The affected segment was resected and an end-to-end anastomosis between the duodenum and jejunum segment was performed. Immunohistochemically, actin and CD34 were positive, Ki67 was positive in <1% of cells, and the proteins CD117 and S100 were negative. CONCLUSION To our best of our knowledge, this is the fourth report of IFP in adolescents, the first in a female's duodenum.
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Affiliation(s)
| | | | | | | | - Rodrigo Daminello Raimundo
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC (FMABC), Santo André, Brazil
| | - Luiz Carlos de Abreu
- Laboratório de Delineamento de Estudos e Escrita Científica, Faculdade de Medicina do ABC (FMABC), Santo André, Brazil
| | - João Antonio Correa
- Full professor, Angiology and Vascular Surgery, Faculdade de Medicina do ABC (FMABC), Santo André, Brazil
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Righetti L, Parolini F, Cengia P, Boroni G, Cheli M, Sonzogni A, Alberti D. Inflammatory fibroid polyps in children: A new case report and a systematic review of the pediatric literature. World J Clin Pediatr 2015; 4:160-166. [PMID: 26566490 PMCID: PMC4637808 DOI: 10.5409/wjcp.v4.i4.160] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/13/2015] [Accepted: 09/30/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To study that inflammatory fibroid polyps (IFPs) in children are extremely uncommon tumors that may occur throughout the gastrointestinal tract.
METHODS: A systematic review of the pediatric literature and a report of a new case of IFP is also presented. The PubMed database was searched for original studies on pediatric IFPs since 1960, according to “Preferred reporting items for systematic reviews and meta-analyses” guidelines for systematic reviews.
RESULTS: Five studies were finally enclosed, encompassing 6 children with IFPs (mean age 64 mo). Tumors were located in the stomach (2 patients), in the small bowel (2 patients), in the rectum (1 patient) and in the colon (1 patient). Open surgery was performed in all patients and complete excision of the mass was achieved in all cases. All patients are alive and free of symptom. Authors described a further case of a 3-year-old boy with a large duodenal IFP, in whom the tumor was removed by “en block resection”. The presence of IFP throughout the gastrointestinal tract and its variable clinical appearances make it difficult to diagnose. An accurate pre-operative assessment is fundamental in order to differentiate IFP from other more aggressive gastrointestinal tumor, enabling unnecessary demolitive surgery.
CONCLUSION: When complete resection of the IFP is achieved, the prognosis is excellent.
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Abstract
Eosinophilic gastroenteritis is defined as a disorder that selectively affects the gastrointestinal tract with eosinophil-rich inflammation in the absence of any known causes for eosinophilia. The clinical manifestations vary according to the site of the eosinophilic infiltrated layer of the bowel wall. Eosinophilic enteritis presenting as intussusception in adult has not been previously reported in the literature. Especially, making the diagnosis of intussusception in adults is often difficult due to the variable clinical findings. In our case, the correct diagnosis of intussusception due to eosinophilic enteritis was arrived at rather easily based on the ultrasonography and endoscopic biopsy. The patient was treated with oral prednisolone at 30 mg/day for 7 days, and then the drug was tapered off for 2 months; we didn't perform surgery. He has been asymptomatic for about 1 year after discharge without disease recurrence.
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Affiliation(s)
- Woon Geon Shin
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Cheol Hee Park
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Young Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kyoung Oh Kim
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kyo-Sang Yoo
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jong Hyeok Kim
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Choong Kee Park
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
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Chongsrisawat V, Yimyeam P, Wisedopas N, Viravaidya D, Poovorawan Y. Unusual manifestations of gastric inflammatory fibroid polyp in a child. World J Gastroenterol 2004; 10:460-2. [PMID: 14760782 PMCID: PMC4724902 DOI: 10.3748/wjg.v10.i3.460] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM: Inflammatory fibroid polyp (IFP) is a rare benign lesion that may occur throughout the digestive tract. IFP is more commonly found in the antrum of the stomach in particular. It mostly affects adults at the average age of 60 years. These polyps are able to cause abdominal pain, gastrointestinal bleeding, intestinal obstruction or intussusception. In this paper we report a case of gastric IFP with unusual presenting features.
METHODS: A child with gastric IFP was described and the literature was reviewed.
RESULTS: A 4-year-old girl presented with fever for 2 months, arthralgia of knees and ankles, iron deficiency anemia, and hypoalbuminemia. Her stool examination was positive for occult blood. The upper gastrointestinal study demonstrated a large lobulated mass at the upper part of gastric body. Partial gastrectomy en bloc with this 5 cm × 8 cm mass was subsequently performed. Pathological examination was consistent with IFP. Following the mass excision, her fever abruptly declined and disappeared together with anemia and arthralgia. She remained asymptomatic and the abdominal ultrasonography performed at the 24-month follow-up demonstrated no recurrence of the tumor.
CONCLUSION: The etiopathogenesis of IFP still remains unclear. The presence of IFP throughout the gastrointestinal tract and its variable clinical appearances make it difficult to diagnose. The inflammatory symptoms found in this patient support the hypothesis of inflammatory benign lesions of IFP.
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Affiliation(s)
- Voranush Chongsrisawat
- Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330 Thailand
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Demirkan NC, Akalin T, Yilmaz F, Ozgenc F, Ozcan C, Alkanat MB, Aydogdu S. Inflammatory myofibroblastic tumor of small bowel wall in childhood: Report of a case and a review of the literature. Pathol Int 2001; 51:47-9. [PMID: 11148464 DOI: 10.1046/j.1440-1827.2001.01158.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Benign intestinal tumors are rare in children, however we describe an inflammatory myofibroblastic tumor (IMT) of the jejunum in a 2-year-old girl who presented with an intestinal obstruction. During laparotomy, an annular mass around the jejunum was resected, from which a histological diagnosis of IMT was made. A review of the literature for this rare entity emphasizes the importance of histological confirmation of its benign nature. Because of the risk of local recurrence, IMT cases should have a long-term follow up.
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Affiliation(s)
- N C Demirkan
- Department of Pathology, Pamukkale University School of Medicine, Denizli, Turkey.
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Abstract
Intussusception is the invagination of one portion of the intestine into another and is the most common form of intestinal obstruction in infants. This report reviews the clinical presentation and diagnostic and treatment options available for intussusception. The etiologies of childhood intussusception are discussed. Details and literature review are provided on the advantages and disadvantages of ultrasonography, barium enema, air contrast enema, and surgery in the diagnosis and treatment of intussusception.
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Affiliation(s)
- J W DiFiore
- Department of Pediatric Surgery, The Cleveland Clinic Foundation Children's Hospital, OH 44195, USA
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Abstract
Intussusception is one of the commonest causes of intestinal obstruction in infants and accounts for about 700 hospital admissions each year in England and Wales. Improved results of treatment have followed recent technological developments, which include ultrasonographic imaging and pneumatic reduction techniques. Most intussusceptions can be reduced successfully without the need for operation but close cooperation between surgeon and radiologist is essential. Mortality and morbidity rates from the condition have progressively declined in recent decades but avoidable deaths still occur.
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Affiliation(s)
- M D Stringer
- Department of Paediatric Surgery, Institute of Child Health, London, UK
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Abstract
A large inflammatory fibroid polyp of the stomach with endo-exophylic growth is described in a 5-year-old. CT and UGI demonstrate the lesion.
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Abstract
A case of inflammatory fibroid polyp of the sigmoid colon is presented. This is the eight case of this type of polyp in the colon and, to the best of our knowledge, the first one involving the sigmoid and producing intussusception. Symptomatology of the inflamed fibroid polyp in this part of the gut closely simulates gastrointestinal malignancy. The treatment is surgical excision of the polyp, or colonoscopic resection when it is possible. Intraoperative colonoscopy helps the surgeon to localize the lesion and to role out the existence of other lesions.
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Abstract
Details of 13 new cases of inflammatory fibroid polyp of the gastrointestinal tract and of 76 patients recorded in the literature (total 89) are described and analysed. The lesion is always benign, may occur at any age but is commonest in the sixth and seventh decades, and involves the stomach most frequently. Abdominal pain, often related to obstruction, is the principal symptom. Eosinophilia of the peripheral blood does not occur. The lesions are sessile or polypoidal, originate in the gut submucosa, vary greatly in cellularity, and have a wide range of tissue eosinophilia. Some are very vascular, many of the larger vessels having a notably broad zone of connective tissue about them. The aetiology of the condition is discussed and reasons for distinguishing it from eosinophilic gastroenteritis, with which it is frequently confused, are given. The precise nature and aetiology of the inflammatory fibroid polyp remains undetermined.
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Hoefer RA, Ziegler MM, Koop CE, Schnaufer L. Surgical manifestations of eosinophilic gastroenteritis in the pediatric patient. J Pediatr Surg 1977; 12:955-62. [PMID: 592075 DOI: 10.1016/0022-3468(77)90606-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Eosinophilic gastroenteritis, an inflammatory bowel disease of unknown etiology, occurs in one of 10,000 admissions to this Children's Hospital. We had added 4 cases to the 11 retrieved from a literature review. The inflammation is characterized by mature eosinophils predominating a transmural process which may produce pain, obstruction, perforation, bleeding, or fistulae. All levels of the gastrointestinal tract are involved, but stomach (25.9%) and small bowel (66.7%) lesions are most common. Eosinophilia occurs in 61% of children and allergy in 13%. X-rays may demonstrate a diffuse or localized process. Operative intervention may be necessary to exclude tumors or regional enteritis, and at times to extirpate complications of local disease, but conservative therapy is the treatment of choice for this exacerbating-remitting disease.
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LiVolsi VA, Perzin KH. Inflammatory pseudotumors (inflammatory fibrous polyps) of the esophagus. A clinicopathologic study. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1975; 20:475-81. [PMID: 1130373 DOI: 10.1007/bf01070794] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
When they involve the gastrointestinal tract, inflammatory pseudotumors, composed of inflamed fibrous and granulation tissue, produce localized, frequently polypoid, masses. These rare lesions have been described in the stomach, small intestine, and colon. Only two have been previously reported in the esophagus. In this paper, 4 cases of inflammatory pseudotumor involving the esophagus are presented. These lesions usually occur in the esophagus as raised, occasionally pedunculated, masses and may be mistaken on radiologic examination and in the operating room for a neoplasm, usually a leiomyoma. Theories concerning pathogenesis of these lesions are considered and the differential diagnostic criteria are discussed.
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LiVolsi VA, Perzin KH. Inflammatory pseudotumors (inflammatory fibrous polyps) of the small intestine: A clinicopathologic study. THE AMERICAN JOURNAL OF DIGESTIVE DISEASES 1975; 20:325-36. [PMID: 1130361 DOI: 10.1007/bf01237789] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The clinical and pathologic features of 25 inflammatory pseudotumors of the small intestine are reported. These rare lesions, which clinically may simulate neoplasms, consist of localized, frequently polypoid masses composed of inflamed fibrous and granulation tissue. Inflammatory pseudotumors may produce intussusception and small-bowel obstruction. Some are found at laparotomy performed for other reasons. The diagnosis of inflammatory pseudotumor usually can not be made until the lesion is examined histogically. Their etiology remains unknown, but their relationship to intestinal ulceration is discussed. Problems in differential histologic diagnosis are considered.
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