INFLAMMATORY MYOFIBROBLASTIC TUMOR (IMT) is a rare TUMOR with unknown etiology which usually occurs in children and adolescents. It is composed of MYOFIBROBLASTIC spindle cells intermixed with INFLAMMATORY cells. Our case was a 15-year-old boy presented with fever, weight loss, anemia and epigastric mass. Radiographic studies showed periduodenal mass with duodenal compression and mild mucosal thickening. Sonography and duodenal biopsy were not contributory. In laparatomy, a peri-duodenal mass with duodenal adhesion was seen during the resection, perforation of duodenum and extrahepatic bile duct occurred. Consequently, duodenostomy and anastomosis of bile ducts were performed. On histological examination, IMT was diagnosed. Manifestation resolved after the removal of the mass and he remained free of recurrence within three years after discharge. Based on the fact that IMT is now generally considered to be a potential neoplasm, clinicians must consider it and it should be added to the list of differential diagnoses of anemia and abdominal mass. In addition, despite benign histological features, a risk of aggressive behaviors of the TUMOR, a long term clinical and radiological follow up of the patients is necessary.

Background: INFLAMMATORY MYOFIBROBLASTIC TUMOR is a rare occurrence in general practice. Its biologic nature, natural history and response to different treatment modalities are obscure.Materials and Methods: We retrospectively reviewed clinical and pathological features of 5 patients with INFLAMMATORY MYOFIBROBLASTIC TUMOR of the lung observed between 1999 and 2006.Results: Under-study patients were 3 women and 2 men with a median age of 32.6 years. All patients were symptomatic. Computed tomography (CT) scan demonstrated a mass in all cases. Four patients underwent surgery (TUMOR resection in 1, lobectomy in 1, bilobectomy in 1 and lobectomy with mediastinal mass debulking also in 1). Complete resection was achieved in 2 patients who are currently alive with no evidence of disease. One died due to progressive disease. Another is alive with disease after incomplete resection, and one refused any kind of surgery. There was no operative mortality. All patients were under follow-up (range, 5 to 60 months; median 39 months).Conclusion: This study illustrates that some INFLAMMATORY MYOFIBROBLASTIC TUMORs behave aggressively and have a poor prognosis. It also confirms that radical resection is the treatment of choice for this malignancy.

INFLAMMATORY MYOFIBROBLASTIC TUMOR is an uncommon benign neoplasm and its presentation in small bowel is rare. Due to clinical manifestation, laboratory data and radiologic results, there is an increased risk of over diagnosis as malignant TUMORs particularly malignant lymphoma in childhood therefore may be resulting in wrong therapeutic approach. However pathologic findings could be demonstrated definite diagnosis based on markedly proliferation of bland looking spindle cells which their presence can be confirmed by immunohistochemistry staining to show MYOFIBROBLASTIC differentiation. We describe here an unusual presentation of INFLAMMATORY MYOFIBROBLASTIC TUMOR of the terminal ileum in a 19-month-old girl who presented with anemia, eosinophilia, intestinal obstruction, focal ossification and dystrophic calcification within the TUMOR.