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Inflammatory myofibroblastic tumour of the duodenum
1Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore. fongss@gmail.com
Singapore Medical Journal
|February 17, 2012
Summary
Rare inflammatory myofibroblastic tumours (IMTs) of the duodenum and pancreas mimic cancer. Surgical resection is the primary treatment, offering a curative outcome for these uncommon gastrointestinal stromal tumours.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Inflammatory myofibroblastic tumours (IMTs) are rare neoplasms with probable immunological origins.
- IMTs in the duodenum and pancreatic head are exceptionally uncommon and often misdiagnosed preoperatively as adenocarcinoma.
- Distinguishing IMTs from pancreatic cancer is crucial for appropriate management.
Observation:
- A case of duodenal IMT causing gastric outlet obstruction is presented.
- Literature review of pancreatic head and duodenal IMTs reveals distinct clinical presentations.
- Pancreatic head IMTs typically manifest as obstructive jaundice, while duodenal IMTs present with gastric outlet obstruction.
Findings:
- Surgical excision is the definitive treatment for both pancreatic head and duodenal IMTs.
- Adjuvant therapies like chemotherapy and radiotherapy are reserved for specific cases, such as incomplete resections or aggressive tumour histology.
- Recurrence rates are low following complete surgical removal, indicating a favorable prognosis.
Implications:
- Accurate preoperative diagnosis of IMTs is essential to avoid aggressive treatment for benign conditions.
- Surgical management provides a curative option for patients with IMTs of the duodenum and pancreas.
- Further research into the aetiology and optimal adjuvant treatment strategies for aggressive IMTs is warranted.
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