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Published on: March 7, 2011
Inflammatory myofibroblastic tumor ofabdomen: computerized tomographic (CT) and pathological findings
Wichchuda Yamrubboon1, Sith Phongkitkarun, Suphaneewan Jaovisidha
1Department of Radiology, Ramathibodi Hospital, Rama 6 Rd, Bangkok 10400, Thailand.
Insights
Inflammatory Myofibroblastic Tumor (IMT), previously known as inflammatory pseudotumor, presents diagnostic challenges. Recognizing variable abdominal IMT imaging findings is crucial for accurate diagnosis and appropriate treatment.
Area of Science:
- Pathology
- Radiology
- Oncology
Background:
- Inflammatory Myofibroblastic Tumor (IMT), formerly inflammatory pseudotumor, is classified as an intermediate-grade fibrous-origin tumor.
- Abdominal IMT cases are infrequent, often presenting with nonspecific signs and symptoms like fever and palpable masses.
- Diagnosis can be challenging due to varied clinical presentations and nonspecific laboratory findings.
Purpose of the Study:
- To review and characterize the imaging findings of abdominal Inflammatory Myofibroblastic Tumors (IMT).
- To highlight the diagnostic difficulties associated with abdominal IMT.
- To emphasize the importance of recognizing diverse IMT presentations for appropriate management.
Main Methods:
- Retrospective review of fibrous-origin tumor cases at Ramathibodi Hospital from January 2001 to December 2005.
- Analysis of 17 cases of IMT, focusing on the 9 abdominal cases.
- Detailed examination of computerized tomographic (CT) imaging for 3 abdominal IMT cases.
Main Results:
- Out of 115 fibrous-origin tumors, 17 were IMTs; 9 occurred in the abdomen.
- Three abdominal IMT cases showed diverse CT findings: hypodense liver mass with rim enhancement, a liver abscess-like lesion, and a large retroperitoneal mass with a growing hepatic lesion.
- Variable imaging findings can mimic other conditions, complicating diagnosis.
Conclusions:
- Abdominal Inflammatory Myofibroblastic Tumors exhibit varied imaging characteristics.
- Accurate recognition of these diverse findings is essential to avoid misdiagnosis and ensure correct treatment.
- Tissue biopsy remains the definitive diagnostic method for IMT.
Abstract:
Inflammatory Myofibroblastic Tumor (IMT) is the recent name of Inflammatory pseudotumor which was in intermediate group of fibrous-origin tumor. The authors retrospectively reviewed such cases in Ramathibodi Hospital from January 2001 to December 2005. There were 115 cases of fibrous-origin tumor which was IMT in 17 cases. Nine cases occurred in the abdomen and only 3 of these had complete computerized tomographic (CT) imaging. One was hypodense liver mass with thick rim enhancement. Another one in the liver presented as a liver abscess which appeared as multiloculated hypodense mass with enhanced septum. The third case was a large malignant-looking retroperitoneal mass and having a small accompanying hepatic lesion which rapidly grew in the follow up study at nine months. IMT in the abdomen was scanty. The diagnosis was done with difficulty because of different signs and symptoms such as fever and palpable abdominal mass. The laboratory findings were nonspecific or within normal limits. Tissue biopsy was the way of definite diagnosis. We reported 3 cases of abdominal IMT with variable imaging findings that may lead to inappropriate treatment. Recognization of such findings will help achieve correct diagnosis.
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