A gastric duplication cyst is a rare congenital malformation of the foregut but inflammatory myofibroblastic tumor (IMT) is a more rare diagnosis. These are mostly asymptomatic and diagnosed incidentally on imaging done for some other cause. It is very difficult to differentiate between these two conditions based on clinical and radiological studies done preoperatively. Endoscopic Ultrasound with Fine Needle Aspiration (EUS-FNA) allows us to correctly diagnose these conditions. However, EUS-FNA carries a high risk of iatrogenic rupture of these lesions with significant infective potential. We present a case of IMT presenting as a Gastric duplication cyst with a brief review of the literature.
Author(s) Details:
Girish D. Bakhshi
Department of General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, India.
Manish S. Hande
Department of General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, India.
Sumit Boricha
Department of General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, India.
Amit Thombare
Department of General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, India.
Chandrakant Sabale
Department of General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, India.
Urvashi Jain
Department of General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, India.
Sakshi Jain
Department of General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, India.
Sangameshwar Kore
Department of General Surgery, Grant Government Medical College and Sir JJ Group of Hospitals, India.
Recent Global Research Developments in Inflammatory Myofibroblastic Tumor: Current Perspectives
Treatment Strategies:
Surgical resection remains the standard treatment for IMTs, but recurrence is possible.
Conventional chemotherapy (e.g., doxorubicin-based regimens) has limited data, and anti-inflammatory treatments show some symptom relief and efficacy against tumor progression.
Molecularly targeted therapies are promising. Approximately half of IMTs harbor anaplastic lymphoma kinase (ALK) fusion genes, while the other half may have targetable fusion genes or mutations (e.g., ROS1, NTRK, RET).
Clinical trials and regulatory approval pathways are essential for effective targeted therapy.
Epidemiology:
IMTs are ultra-rare sarcomas, with an incidence of <1 per 100,000 per year.
About 50–60% of reported IMT cases occur in children and young adults.
Genomic Landscape:
Comprehensive molecular analysis revealed the genomic landscape and intertumor heterogeneity of IMTs [2] .
ALK fusion genes are common, but other potential targets exist.
Immunotherapy and Prognostic Factors:
Research explores immunotherapy possibilities and resistance to systemic therapy [3] .
Understanding prognostic and predictive factors is crucial.
References
- Kenji Nakano, Inflammatory myofibroblastic tumors: recent progress and future of targeted therapy, Japanese Journal of Clinical Oncology, Volume 53, Issue 10, October 2023, Pages 885–892, https://doi.org/10.1093/jjco/hyad074
- Lee, C. J., Schöffski, P., Modave, E., van Wezel, T., Boeckx, B., Sufliarsky, J., … & Wozniak, A. (2021). Comprehensive molecular analysis of inflammatory myofibroblastic tumors reveals diverse genomic landscape and potential predictive markers for response to crizotinib. Clinical Cancer Research, 27(24), 6737-6748.
- Chmiel, P., SłOWIKOWSKA, A. L. E. K. S. A. N. D. R. A., Banaszek, Ł., Szumera-CIEćKIEWICZ, A., Szostakowski, B., SPAłEK, M. J., … & Czarnecka, A. M. (2024). Inflammatory myofibroblastic tumor from molecular diagnostics to current treatment. Oncology Research, 32(7), 1141.
