Exophytic inflammatory myofibroblastic tumor of the stomach in an adult woman: A rare cause of hemoperitoneum

Figure 1 Abdominal CT revealed a large solid mass at the gastrocolic ligament or the gastric wall, which showed heterogeneous density on an non-enhanced image (A). The 8 cm mass showed internally enhanced vessels on the arterial phase of CT and delayed peripheral enhancement of the mass on the venous phase (B-D).

Figure 2 Contrast-enhanced MRI of the abdomen showed a mass of approximately 8 cm, seen at the left upper quadrant of the abdomen. The margin of the mass was lobulating, and it was attached to the greater curvature of the stomach. It contained a peripheral enhanced solid portion and a central non-enhancing portion (A). Signal intensity of the central non-enhancing portion was low on T1WI (B) and T2WI (C and D), which suggested internal hemorrhage within the tumor.

Figure 3 Laparoscopic view of the exophytic gastric mass with a large amount of intra-abdominal non-clotting hemorrhage.

Figure 4 The external surface of a well-encapsulated lump of soft solid tumor, weighing 88. 1 g, was smooth and glistening, but showed no gastric mucosal lesion (A). Cross-sectional surface of the tumor was characterized by several amorphous fragments of parenchymal tissue, which were separated by the cystic spaces (B).

Figure 5 A: The tumor was composed of round and spindle-shaped myofibroblastic cells. Diffusely scattered inflammatory cells and many vascular structures are seen (HE, × 400); B: The tumor cells showed positive immuno-reactivity for vimentin (× 400).