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Inflammatory pseudotumor of the mesentery and small intestine
Insights
Three children with abdominal inflammatory pseudotumor, a rare mesenteric mass, experienced fever and growth failure. Surgical removal resolved symptoms, confirming the lesion
Area of Science:
- Pediatric Surgery
- Pediatric Oncology
- Gastroenterology
Background:
- Inflammatory pseudotumor (or inflammatory myofibroblastic tumor) is a rare mesenchymal neoplasm.
- Mesenteric tumors in children can present with non-specific systemic symptoms, complicating diagnosis.
Observation:
- Three preadolescent children presented with abdominal masses, fever, growth failure, anemia, thrombocytosis, and polyclonal hypergammaglobulinemia.
- Radiographic imaging confirmed the presence of a solid mesenteric mass in all cases.
- Histopathological examination revealed spindle cells with myofibroblastic features, plasma cells, and lymphocytes.
Findings:
- Surgical resection of the abdominal inflammatory pseudotumor led to the dramatic resolution of systemic manifestations.
- Post-operative follow-up over 3-6 years showed no signs of recurrence, indicating a benign clinical course.
- The tumor was characterized by a proliferation of myofibroblasts, plasma cells, and lymphocytes.
Implications:
- Early surgical intervention is crucial for managing pediatric abdominal inflammatory pseudotumors.
- Complete resection ensures favorable outcomes and prevents recurrence in affected children.
- This case series highlights the importance of considering inflammatory pseudotumors in the differential diagnosis of pediatric abdominal masses with systemic symptoms.
Abstract:
Three cases of abdominal inflammatory pseudotumor or inflammatory myofibroblastic tumor of the small intestinal mesentery are presented with additional examples from the literature. An abdominal mass was detected in three preadolescent children who presented with fever, growth failure, hypochromic anemia, thrombocytosis and polyclonal hypergammaglobulinemia. The radiographic findings confirmed the presence of a mass. Following surgical resection, the systemic manifestations dramatically resolved. The solid mesenteric mass was composed of spindle cells with the features of myofibroblasts and mature plasma cells and small lymphocytes. Clinical follow-up confirmed the benign nature of this lesion with no signs of recurrence in any patient from 3 to 6 years after the initial surgery.