ABSTRACT
INTRODUCTION AND IMPORTANCE: Primary inflammatory myofibroblastic tumor is a rare subgroup of mesenchymal tumors. Gastric localization is extremely rare, and patients may present with abdominal pain and a palpable abdominal mass. Here, we present a case of gastric inflammatory myofibroblastic tumor revealed by abdominal pain, which was treated with wide local excision. CASE PRESENTATION: This report illustrates the case of a 55-year-old female who presented with abdominal pain. Imageology and gastrointestinal endoscopy revealed a posterior gastric mass, which was treated with wide local excision. Immunohistochemical analysis of the specimen confirmed the diagnosis of inflammatory myofibroblastic gastric tumor. The patient had an uneventful postoperative course and she remained in remission after 6 months of follow-up. DISCUSSION: Inflammatory myofibroblastic tumor is a very rare mesenchymal tumor that usually affects children and young adults. Gastric localization is also very rare and does not typically cause specific clinical symptoms. Surgery is the mainstay of treatment, and resection depends on the size and location of the lesion. The definitive diagnosis is confirmed by immunohistochemical analysis of the specimen. CONCLUSION: Myofibroblastic tumor is a rare subgroup of mesenchymal tumor. Gastric localization is an uncommon presentation. Surgery is the mainstay of the treatment. Histological analysis of the surgical specimen is essential for a final diagnosis.
ABSTRACT
Treatment of diffuse large B-cell lymphoma (DLBCL) is based on immunochemotherapy with overall good outcomes. Complications related to the treatment or the disease itself can occur during follow-up. We herein report a case of a 37-year-old male who was diagnosed with stage IV gastric DLBCL. Subsequently, he underwent R-CHOP (rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisone) chemotherapy. After six cycles of treatment, complete remission has been achieved. But afterwards, the patient presented with a symptomatic gastric obstruction related to a tight stenosis in the antro-fundic junction. Endoscopic dilation was performed and multiple macrobiopsies within the stenosis were taken. Pathological examination concluded to the fibrous character of the stricture. In cases of post-chemotherapy obstruction in gastric DLBCL, endoscopic treatment should be attempted carefully in patients with no evidence of active lymphoma. Diagnosis of fibrosis can avoid surgery and its morbidity.
ABSTRACT
Collision tumor of the appendix is an extremely rare entity, defined as the coexistence of two independent tumors located in the same site without transitional changes. We describe in this report the case of a 75-year-old man who presented with an acute abdominal pain, nausea and vomiting. Physical examination revealed an abdominal distension with a hypogastric mass. Abdominal computed tomography showed colonic obstruction related to a sigmoid tumor. Therefore, a total colectomy was made. Macroscopic specimen examination showed a sigmoid tumor associated to a cystic dilatation of the appendix tip with mucoid content. Histological examination of the appendix showed the co-existence of two independent tumors located in the tip, without transitional changes: pTis low-grade appendiceal mucinous neoplasia and grade 1 neuroendocrine tumor. The latter was discovered incidentally during histological examination. We draw attention through our presentation to the importance of a thorough macroscopic and histological examination of the appendix.