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Inflammatory myofibroblastic tumor involving the pterygopalatine fossa.

SUMMARY: Inflammatory myofibroblastic tumors (IMT) comprise a rare group of lesions characterized histologically by acute and chronic inflammatory cells with a variable degree of fibrous stroma. Occurrence in the extracranial head and neck in children is unusual, and involvement in the pterygopalatine fossa has not, to our knowledge, been reported as occurring in this age group. We present the CT findings of an IMT of the pterygopalatine fossa in a 6-year-old female patient with a 2-week history of fever and a painless swelling of the left cheek. The diagnosis of IMT should be included in the differential diagnosis of a child presenting with an aggressive mass associated with systemic features such as fever, elevated sedimentation rate, and leukocytosis.

Child↗

[Myogenic stromal tumors of the stomach: personal experience].

Myogenic gastric tumours are a rare pathology and present difficulties in terms of nosographic classification, which in most cases can be overcome thanks to improvements in imaging and immunohistochemical techniques. Over the period 1995-1999 we observed 5 patients with aspecific dyspeptic symptoms and occasional epigastric pain, suffering from non-epithelial gastric tumours, associated, in one case, with a carcinoma of the stomach. Histological examination of endoscopic biopsies was inconclusive for a definite histopathological diagnosis, while intraoperative biopsies showed the myogenic origin and the absence of morphostructural abnormalities. In the light of these data, we performed three wedge resections, one distal gastric resection and, in the patient with advanced gastric cancer, a D3 total gastrectomy. Histological examination, immunohistochemistry and cytofluorometry enabled us to diagnose stromal tumours with a low risk of malignancy in all cases. At follow-up after 9-54 months all patients are still alive and free of disease. Though the preoperative diagnosis of stromal tumours is possible with endosonography and CT, only histology, immunohistochemistry and cytofluorometry enable us to define the condition nosographically and establish a prognosis with sufficient accuracy to allow correct surgical treatment. A prolonged follow-up is always necessary to identify eventual relapses and/or metastases, which are particularly frequent in the borderline group or in cases with a high risk of malignancy.

Adult↗