Presentation
Abdominal pain with palpable left paramedian mass.
Patient Data
A relatively well-circumscribed left paramedian intramesenteric soft tissue mass mimicking a thick-walled bowel loop. It elicits an intermediate signal intensity with central necrosis of high signal on T2, T2 fat sat and STIR with moderate heterogeneous enhancement of the peripheral solid component and restricted diffusion. Surrounding fat stranding is noted with displacement of the adjacent bowel loops.
Case Discussion
MRI features an intramesenteric soft tissue mass with central necrosis and surrounding fat stranding.
The patient went on to have an ultrasound-guided biopsy with a histopathological study that confirmed the diagnosis of an inflammatory myofibroblastic tumor.
Inflammatory myofibroblastic tumors (IMT), also known as plasma cell granulomas, are rare neoplasms that have a diverse spectrum of biological behavior. They are composed of spindle cells (key feature) with a variable infiltrate of inflammatory cells and fibrous tissue. The more common sites are the lung, abdominal cavity, retroperitoneum and extremities.