Can Chemotherapy Facilitate Less Morbid Surgery in Multicentric Intra-abdominal Inflammatory Myofibroblastic Tumor?

Background: Inflammatory myofibroblastic tumor is a rare benign neoplasm affecting young adults and children. Although often considered benign, its locally aggressive nature and tendency to recur make its management immensely challenging, particularly without robust evidence to guide treatment. Surgical excision offers the best hope for a cure; however, this can lead to significant morbidity and may not always be possible, especially for multicentric diseases.

Case presentation: We report a multicentric abdominal inflammatory myofibroblastic tumor in a 6-year-old girl who presented with massive abdominal distention. The sheer size of the mass, coupled with multicentric presentation and absent mobility on clinical examination, would have led to a very morbid surgical exploration. This patient was treated with initial chemotherapy, which led to a dramatic response in both symptoms and size of masses, facilitating a complete surgical resection with negligible postoperative morbidity.

Conclusions: Although surgery is the preferred treatment for a resectable disease, initial chemotherapy for multicentric or locally advanced inflammatory myofibroblastic tumors facilitates complete surgical resection.