Regression of Inflammatory Myofibroblastic Tumor of the Gastrointestinal Tract Under Infliximab Treatment

Abstract

Inflammatory myofibroblastic tumor (IMFT) is an uncommon mesenchymal neoplasm composed of proliferating myofibroblasts and an accompanying lymphoplasmacytic infiltration (1, 3). Most patients are young, and IMFT is presented as a mass, with or without constitutional manifestations. The most commonly involved visceral site is the lung, followed by the abdominal cavity (1, 2). Although most IMFTs follow a nonrecurring clinical course after complete surgical excision, a subset of cases may be locally aggressive, recurrent, transformed, or, rarely, metastatic (1, 2). Because of the fact that IMFTs can be confused with both reactive processes and potentially malignant neoplasms, distinguishing them from their histologic mimics is very critical in establishing the most appropriate patient management. Although IMFTs are considered by some investigators to be reactive in nature (inflammatory pseudotumors), other investigators suggest a neoplastic pathogenesis (4, 7). The only established treatment is, if possible, complete surgical excision. In this communication, we describe, for the first time, a case of recurrent, aggressive IMFT of intestinal origin infiltrating the mesentery, which regressed almost completely under anti-TNF-α binding antibody (infliximab) infusion treatment.