Inflammatory Myofibroblastic Tumor of the Gallblader

Abstract

Background: Inflammatory myofibroblastic tumors are rare benign tumors that can mimic malignancy. Their precise aetiology is unknown. They are seen more frequently in childhood and the most common involvement is seen in the lungs. Primary inflammatory myofibroblastic tumors of the gallbladder are rather infrequent. The present knowledge is based on case reports. Case Report: A 66 year-old male patient presented to the hospital with complaints of abdominal pain, nausea and vomiting. Upon physical examination, a clinical picture of abdominal tenderness on the right upper quadrant of the abdomen was identified. Laboratory examinations revealed leukocytosis and hypochromic microcytic anaemia with an increased erythrocyte sedimentation rates and C-reactive protein levels. A mass almost completely filling the gallbladder was detected by imaging studies. The patient was operated on with a malignant preoperative diagnosis and underwent a liver resection of segments 4 and 5, which included a cholecystectomy. The histopathological examination of the surgical specimen revealed an inflammatory myofibroblastic tumor including many histiocytes stained positively with CD 68. Conclusion: Inflammatory myofibroblastic tumors can be localised in the gallbladder mimicking gallbladder cancer. Turkish Başlık: Safra Kesesinin Primer Inflamatuvar Myofibroblastik Tümörü Anahtar Kelimeler: Inflamatuar myofibroblastik tümör, safra kesesi, safra kesesi kanserleri Arkaplan: İnflamatuvar myofibroblastik tümör nadir rastlanan maligniteyi taklit edebilen benign tümörlerdir. Etiyolojisi kesin olarak bilinmemektedir. Çocukluk yaş grubunda sık görülmekle birlikte en sık akciğeri tutmaktadır. Safra kesesinin primer inflamatuvar myofibroblastik tümörlerine oldukça nadir rastlanmaktır. Mevcut bilgiler olgu sunumlarından ibarettir. Olgu Sunumu: 66 yaşında erkek hasta, karın ağrısı, bulantı ve kusma şikâyetleri nedeniyle başvurdu. Fizik muayenesinde karın sağ üst kadranda periton hassasiyet tablosu saptandı. Laboratuar incelemelerinde lökositoz ve hipokrom mikrositer aneminin yanı sıra eritrosit sedimantasyon hızı ve c-reaktif protein hızında artmış saptandı. Görüntüleme yöntemlerinde safra kesesi içerisinde keseyi tama yakın dolduran kitle imajı saptandı. Malignite ön tanısıyla ameliyata alınan hastanın safra kesesi segment 4 ve 5 ‘in dâhil edildiği segmenter karaciğer rezeksiyonu ile rezeke edildi. Ameliyat materyalinin histopatolojik incelemesi sonucunda CD 68 pozitif boyama gösteren çok sayıda histiositlerin bulunduğu inflamatuvar myofibroblastik tümör saptandı. Sonuç: İnflamatuar myofibroblastik tümörlerin safra kesesinde lokalize olabileceği ve safra kesesi kanserini de taklit edebileceği akılda tutulmalıdır.

Keywords

• Inflammatory myofibroblastic tumor, gallbladder, gallbladder tumor

Inflammatory Myofibroblastic Tumor of the Gallblader

Öz

Kaynakça

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