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12 February 2016 : Case report  Lebanon

Highly Vascularized Primarily Inflammatory Pseudotumor of the Omentum in an Adult Male: A Case Report

Challenging differential diagnosis, Rare disease

Hiba Hassan El Hage ChehadeAEF, Riad Hassan ZbiboAE, Bassem Mahmoud Abou HusseinDE, Houssam Khodor AbtarAEF

DOI: 10.12659/AJCR.896036

Am J Case Rep 2016; 17:79-83

Abstract

BACKGROUND: Inflammatory pseudotumors can affect any organ, whereas primary omental tumors are very rare. A few cases have been reported in the literature, all affecting adult patients. They are usually difficult to diagnose preoperatively and pathology remains the criterion standard for diagnosis. Surgical resection is considered the first-line treatment in limited disease, whereas recurrent or metastatic disease is treated by re-excision. There is no role for chemo- or radio-therapy in limited disease. Here, we present a rare case of omental myofibroblastic tumor in an adult male.

CASE REPORT: A 38-year-old healthy man presented to our clinic complaining of lower abdominal pain associated with anorexia and low-grade fever, and he also reported weight loss. His initial hemoglobin was 9.7 g/dl. Magnetic resonance imaging (MRI) showed an enhancing solid mass in the lower abdomen, with close proximity to the appendix and the urinary bladder. The patient was treated successfully with laparotomy and excision of the tumor. Histopathology of the mass revealed spindle cells of vague fascicular pattern. Further immunohistochemical staining showed presence of reaction for CD68, CD34, and ALK. No omental infiltration was noted. No adjuvant treatment was applied and the patient was free of disease after 1-year follow-up.

CONCLUSIONS: Omental pseudotumors are a rare pathology. They are usually slowly- growing, circumscribed tumors with a low malignant potential. They have a predilection for children. The overall mortality is reported to be 5–7% in cases with multiple recurrences.

Keywords: Granuloma, Plasma Cell - surgery, Hemoglobins - analysis, Omentum - surgery, Peritoneal Diseases - surgery

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923