A CASE OF PRIMARY RETROPERITONEAL INFLAMMATORY MYOFIBROBLASTIC TUMOR DETECTED BY UPPER GASTROINTESTINAL ENDOSCOPY AND PREOPERATIVELY DIAGNOSED BY ENDOSCOPIC ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION

Abstract

[Case] A male in his 70s was being followed for walled-off pancreatic necrosis subsequent to acute pancreatitis. A computerized tomography (CT) scan obtained six months previously showed no lesions. Upper gastrointestinal endoscopy at the current visit revealed a submucosal tumor of about 2 cm in size at the gastric cardia. Since the tumor could not be differentially diagnosed by imaging and tended to become larger, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed, and an inflammatory myofibroblastic tumor was diagnosed. The tumor was completely resected by laparoscopy and partial gastrectomy. Histopathologically, the final diagnosis was intermediate malignant primary retroperitoneal inflammatory myofibroblastic tumor. There has been no recurrence 18 months after the surgery.

[Discussion] We encountered a case in which a gastric submucosal tumor detected by upper gastrointestinal endoscopy, and EUS-FNA was useful for establishing the preoperative diagnosis of an inflammatory myofibroblastic tumor.