Vaibha Raj Gopal, e al. In lamma o y Myo ib oblas ic Tumou o Ileo-Caecal Junc ion P esen ing as Acu e In es inal
Obs uc ion wi h Re ocolic Abscess in A Young Female- A Case Repo . In . J Med. Pha m. Res., 6 (6): 421‐426, 2025
421
In e na ional Jou nal o Medical
and Pha maceu ical Resea ch
Online ISSN-2958-3683 | P in ISSN-2958-3675
F equency: Bi-Mon hly
A ailable online on: h ps://ijmp .in/
Case Repo
In lamma o y Myo ib oblas ic Tumou o Ileo-Caecal Junc ion P esen ing as
Acu e In es inal Obs uc ion wi h Re ocolic Abscess in A Young Female- A
Case Repo
Vaibha Raj Gopal1*; Mi hlesh Bha ga 2; Fa az Ahmad3; Neelam Kuma i4
1Assis an P o esso , Depa men o Gene al Su ge y, King Geo ge’s Medical Uni e si y Lucknow, U a P adesh, India
2Assis an P o esso , Depa men o Pa hology, All India Ins i u e o Medical Sciences Go akhpu , U a P adesh, India 2.
3Addi ional P o esso , Depa men o Gene al Su ge y King Geo ge’s Medical Uni e si y Lucknow, U a P adesh, India 3.
4Senio Residen , Depa men o Gene al Su ge y King Geo ge’s Medical Uni e si y Lucknow, U a P adesh, India
A B S T R A C T
Co esponding Au ho :
Vaibha Raj Gopal
Assis an P o esso , Depa men o
Gene al Su ge y, King Geo ge’s
Medical Uni e si y Lucknow, U a
P adesh, India
Recei ed: 05-10-2025
Accep ed: 04-11-2025
A ailable online: 16-11-2025
Backg ound: In lamma o y myo ib oblas ic umou (IMT) is a e y a e
mesenchymal umou wi h an unclea benign o malignan po en ial. Lung is he
mos common si e o occu ence bu less equen ly i also occu s a a ious ex a
pulmona y si es. Common si es in abdomen include e ope i oneum and mesen e y.
Comple e su gical excision is he s anda d o ca e and malignan a ian s need o be
suppo ed wi h adju an a ge ed he apy wi h ALK inhibi o s.
Case epo : We p esen he e a case o IMT o ileo-caecal junc ion p esen ing as
ank acu e in es inal obs uc ion in an 18 yea old emale which highligh s he
po en ial o his umou o causing li e h ea ening eme gencies. Pa ien unde wen
lapa o omy wi h igh hemicolec omy. His opa hology was consis en wi h IMT o
ileocaecal junc ion wi h no a ypia. Pa ien was kep on egula ollow up and
p esen ly she is asymp oma ic.
Conclusion: IMT is mainly a his opa hological diagnosis and comple e su gical
excision wi h nega i e ma gins o e s he bes ea men . Owing o he isk o
ecu ence and malignan po en ial, egula ollow up is manda o y and a ge ed
he apy ia ALK inhibi o s is wa an ed in such si ua ions
Copy igh © In e na ional Jou nal o
Medical and Pha maceu ical Resea ch
Keywo ds: In lamma o y myo ib oblas ic umou , ileocaecal junc ion, acu e
abdomen.
INTRODUCTION
In lamma o y myo ib oblas ic umou (IMT) is a e y a e mesenchymal umou wi h an unclea benign o malignan
po en ial. I is mos ly epo ed as o benign o igin and i s incidence is less han 1 % in he popula ion.[1],[2] Common
si es o i s occu ence include lung, nose, h oa , skin and ex emi ies. In aabdominal loca ions like omen um, mesen e y
and e ope i oneum ha e been epo ed in li e a u e bu o e all incidence is ex emely low.[3],[4],[5],[6]Clinical ea u es
o his condi ion a e si e speci ic and su gical excision is he mos common ea men o choice. In aabdominal IMT
usually p esen s wi h abdominal pain, al e ed bowel habi s, bleeding pe ec um, in ussuscep ion and abdominal lump.
We p esen he e a case o IMT o ileo-caecal junc ion p esen ing as ank acu e in es inal obs uc ion in a young emale
which highligh s he po en ial o his umou o causing li e h ea ening eme gencies.
Case p esen a ion
An 18 yea old emale p esen ed in su gical eme gency wi h complains o pain in abdomen wi h dis ension and inabili y
o pass la us and eces o 5 days. She also had o and on low g ade e e o 1 week and episodic omi ing. She had no
his o y o simila complains in he pas . He mens ual his o y was wi hin no mal limi s and she had no his o y o con ac
wi h any ube culosis pa ien o an i ube cula d ug in ake.He i als a he ime o p esen a ion we e: Blood p essu e:
110/70 mmHg, Pulse a e: 100/ minu e, espi a o y a e: 18/ minu e, empe a u e: a eb ile. On examina ion he abdomen
Vaibha Raj Gopal, e al. In lamma o y Myo ib oblas ic Tumou o Ileo-Caecal Junc ion P esen ing as Acu e In es inal
Obs uc ion wi h Re ocolic Abscess in A Young Female- A Case Repo . In . J Med. Pha m. Res., 6 (6): 421‐426, 2025
422
was dis ended and bowel sounds we e absen . She also had ende ness in he igh uppe and igh lowe quad an o
abdomen. Pa ien had a con as CT scan done om somewhe e else which was also sugges i e o mul iple pocke s o
collec ion in he igh pa acolic gu e wi h maximum olume o 322 ml and non- isualisa ion o appendix and dila ed
small bowel loops. Based on hese clinical and adiological indings, diagnosis o acu e la ge bowel obs uc ion wi h
suspec ed appendicula pe o a ion was made. Pa ien was planned o su gical explo a ion.
On explo a ion small bowel loops we e g ossly dila ed, a ha d obs uc ing mass was p esen in he ileo-caecal junc ion
wi h app oxima ely 350 ml pus in he e ocolic egion wi h g ossly dila ed small bowel loops. No ob ious pe o a ion
was ound a he umou si e bu he appendix could no be iden i ied du ing dissec ion which aised he possibili y o
sealed appendicula pe o a ion. Righ hemicolec omy wi h e acua ion o pus and ileo- ans e se anas omosis was done.
Specimen was sen o his opa hology. Pos ope a i e ou come was une en ul and she was o ally allowed on 7 h day and
abdominal d ain was emo ed on 8 h day. She was discha ged on 9 h day and was ad ised ollow up wi h he
his opa hology epo o u he managemen . On ollow up a e a week she had no esh complains and he
his opa hology was sugges i e o in lamma o y myo ib oblas ic umou o ileo-caecal junc ion wi h no e idence o
malignancy. Pa ien was kep unde egula ollow up e e y mon h o one yea and p esen ly she is asymp oma ic. No
adju an ea men ei he medical o adia ion was gi en.
Figu es
Figu e 1a
Figu e 1b
Vaibha Raj Gopal, e al. In lamma o y Myo ib oblas ic Tumou o Ileo-Caecal Junc ion P esen ing as Acu e In es inal
Obs uc ion wi h Re ocolic Abscess in A Young Female- A Case Repo . In . J Med. Pha m. Res., 6 (6): 421‐426, 2025
423
Figu e 1c
Figu e 1 a,b,c : CECT scan sugges i e o mul iple pocke s o collec ion wi h ai oci in igh pa acolic gu e wi h di use
long segmen hickening o ascending colon and caecum wi h obs uc ing lesion a ileo-caecal junc ion and dila ed small
bowel loops.
Figu e 2 : G ossly dila ed bowel loops wi h pus lakes
Vaibha Raj Gopal, e al. In lamma o y Myo ib oblas ic Tumou o Ileo-Caecal Junc ion P esen ing as Acu e In es inal
Obs uc ion wi h Re ocolic Abscess in A Young Female- A Case Repo . In . J Med. Pha m. Res., 6 (6): 421‐426, 2025
424
Figu e 3: Righ hemicolec omy specimen wi h a pa o e minal ileum showing g ow h a he ileocaecal junc ion
Figu e 4 a
Figu e 4 b
Vaibha Raj Gopal, e al. In lamma o y Myo ib oblas ic Tumou o Ileo-Caecal Junc ion P esen ing as Acu e In es inal
Obs uc ion wi h Re ocolic Abscess in A Young Female- A Case Repo . In . J Med. Pha m. Res., 6 (6): 421‐426, 2025
425
Figu e 4 a,b : Sec ions om g ow h show di use a eas o ulce a ed mucosa and displaying panmu al p oli e a ion o
myo ib oblas s and ib oblas ic spindle cells wi h in ense mixed in lamma o y cell in il a e comp ising o lymphocy es,
plasma cells, his iocy es and polymo phs. These myo ib oblas s a e o al o spindle shaped, ha ing bland nuclea
ch oma in, mic o-nucleoli ha ing ill-de ined eosinophilic cy oplasm. Fai numbe o p oli e a ing blood essels and
conges ed ascula channels a e also seen. No e idence o g anuloma o malignancy.
Discussion
Acu e in es inal obs uc ion (AIO) is a su gical eme gency necessi a ing su gical explo a ion and cause di ec ed
ea men . Common causes o AIO in adolescen popula ion in India include adhesions, he nia ion, ube culosis[7],
in ussuscep ion, and less commonly neoplasia. Mos o he imes he diagnosis is clinical and he su geon does no wai
o he sophis ica ed adiological es s o subs an ia e he clinical inding. An e ec abdominal X- ay is su icien o aid
in he diagnosis and head o su gical explo a ion. Hence a p ope p e-ope a i e diagnosis is no possible in majo i y o
AIO. In ou case also he clinical signs and symp oms we e sugges i e o acu e bowel obs uc ion and she had a CT scan
done a some o he cen e which was also consis en wi h he clinical diagnosis hence we p oceeded o explo a o y
lapa o omy.
IMT is mainly a his opa hological diagnosis and is mos ly ega ded as a benign umou wi h a e y low chance o
ecu ence when comple ely excised. Though i usually occu s in young age and is gende non-speci ic, i s p esen a ion
in old age has also been epo ed.[8] Some isk ac o s like auma, associa ion wi h Eps ein Ba i us, Human He pes -
8 i us, a ious au oimmune p ocesses, IgG-4 ela ed diseases ha e been iden i ied bu hey don’ hold a one o one
causal ela ionship wi h he disease p ocess.[9],[10] Lung is he mos common si e and mesen e y and omen um
cons i u e he mos common si e in he abdomen. Comple e su gical excision o he umou wi h nega i e ma gins is he
bes ea men ill da e. IMTs o small bowel, sigmoid colon and ans e se colon p esen ing as AIO ha e also been
epo ed in li e a u e bu he o e all equency is sca ce.[11],[12] Owing o he a i y o his disease, s anda dised
guidelines o managemen and ollow up s ill lack in he li e a u e.
Rega ding he malignan po en ial o IMTs, i is epo ed o be o less han 5% and p ognosis depends on he g ade o
umou , me as asis and ALK gene posi i i y. [13]Tumou s wi h ALK gene posi i i y ha e a good p ognosis and his gene
exp ession is seen in a ai numbe o IMTs.[14], [15]C ezo inib, an ALK gene (anaplas ic lymphoma kinase) inhibi o is
he a ge ed he apy d ug which is app o ed o IMT wi h a ai esponse a e o 60-70%. I is e y commonly used in
lung IMT and in cases o locally agg essi e lesions and me as asis.[16] The e is a g owing body o e idence in li e a u e
ega ding he s e oid he apy o IMTs o di e en si es like lung and maxilla y sinus wi h a posi i e esponse h ough
unknown mechanisms bu his in e en ion will equi e consolida ion and au hen ica ion ia u he s udies.[17]
Malignan gas ic IMT wi h di use pe i oneal and li e me as asis has also been epo ed in li e a u e and hence
malignan na u e o IMT canno be o e looked and e en a e comple e excision, egula ollow up o he pa ien wi h
local examina ion and adiological imaging is manda o y.[13] Epi helioid in lamma o y myo ib oblas ic sa coma (EIMS)
is also a malignan and agg essi e a ian o IMT which ca ies a high me as a ic po en ial and poo p ognosis and i
p esen s in olde age wi h a male p eponde ance. On immunos aining i is di e en ia ed om he egula IMT by
pe inuclea ALK gene s aining and RANBP-2/ALK usion gene a angemen as compa ed o cy oplasmic ALK gene
s aining in he la e . EIMS o ileocaecal junc ion has also been epo ed in li e a u e.[18]
Conclusion
Ileo-caecal junc ion IMT p esen ing as AIO is a e y a e case scena io and su gical managemen is in acco dance wi h
he managemen p o ocol o AIO and should be guided by he gene al condi ion o he pa ien , o e all ex en o disease,
easibili y o esec ion wi h o wi hou s oma c ea ion o anas omosis. P eope a i e his opa hological diagnosis should
only be ese ed o s able pa ien s no equi ing eme gency su ge y. Since malignan po en ial and ecu ences ha e
also been desc ibed, egula ollow up is necessa y. Fu he esea ch and s udies a e equi ed o be e unde s anding o
IMT pa hogenesis and gene ics o inno a ion o e ined diagnos ic es s, no el chemo he apeu ic agen s o a ge ed
he apy and p edic ion o p ognosis. P esen ly, comple e excision o he umou wi h nega i e ma gins, i possible is
conside ed o be he s anda d o ca e.
Funding Sou ces/ Financial suppo : none decla ed
Con lic s o in e es : none decla ed
Pa ien ’s pe mission: w i en and in o med consen aken
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