Case Report
Copyright ©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Clin Cases. Apr 16, 2014; 2(4): 111-119
Published online Apr 16, 2014. doi: 10.12998/wjcc.v2.i4.111
Rare case of an abdominal mass: Reactive nodular fibrous pseudotumor of the stomach encroaching on multiple abdominal organs
Xiao-Jiang Yi, Chuang-Qi Chen, Yin Li, Jin-Ping Ma, Zhi-Xun Li, Shi-Rong Cai, Yu-Long He
Xiao-Jiang Yi, Chuang-Qi Chen, Yin Li, Jin-Ping Ma, Shi-Rong Cai, Yu-Long He, Department of Gastrointestinal Surgery and Colorectal Surgery, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
Zhi-Xun Li, Department of Pathology, the First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, Guangdong Province, China
Author contributions: Yi XJ and Chen CQ conducted the literature review, drafted and revised the manuscript, and approved the final submitted draft; Li Y performed the gastroscopy in the patient and provided the gastroscopic report and pictures; Li ZX conducted the gastroscopic and postoperative pathological evaluation of the biopsy and provided the pathological reports and pictures; Ma JP, Cai SR and He YL revised the manuscript and approved the final submitted draft.
Correspondence to: Chuang-Qi Chen, MD, PhD, Professor of Surgery, Department of Gastrointestinal Surgery and Colorectal Surgery, the First Affiliated Hospital, Sun Yat-Sen University, No. 58, Zhongshan 2nd Road, Guangzhou 510080, Guangdong Province, China. ccqsums@gmail.com
Telephone: +86-20-87755766 Fax: +86-20-87333122
Received: October 7, 2013
Revised: March 2, 2014
Accepted: March 13, 2014
Published online: April 16, 2014
Processing time: 185 Days and 0.1 Hours
Abstract

Reactive nodular fibrous pseudotumor (RNFP), which presents abdominal clinical manifestations and malignant radiographic results, usually requires radical resection as the treatment. However, RNFP has been recently described as an extremely rare benign post-inflammatory lesion of a reactive nature, which typically arises from the sub-serosal layer of the digestive tract or within the surrounding mesentery in association with local injury or inflammation. In addition, a postoperative diagnosis is necessary to differentiate it from the other reactive processes of the abdomen. Furthermore, RNFP shows a good prognosis without signs of recurrence or metastasis. A 16-year-old girl presented with a 3-mo history of epigastric discomfort, and auxiliary examinations suggested a malignant tumor originating from the stomach; postoperative pathology confirmed RNFP, and after a 2-year follow-up period, the patient did not display any signs of recurrence. This case highlights the importance of preoperative pathology for surgeons who may encounter similar cases.

Keywords: Reactive nodular fibrous pseudotumor; Post-inflammatory lesion; Digestive tract; Mesentery; Good prognosis

Core tip: Our case report describes a rare benign tumor originating from the gastrointestinal tract. To date, this lesion has been reported in 20 cases worldwide. The most significant and important insights are that these diseases possess fairly good prognosis with opposite radiographic and clinical findings. Pathologically, reactive nodular fibrous pseudotumor (RNFP) was recently described arising from the sub-serosal layer or within the surrounding mesentery. However, the veracity of the pathological examination results and the etiology are still controversial. We will describe the complete diagnostic and therapeutic process of a young girl with RNFP and will retrospectively analyze the previously reported cases, particularly the microscopic and immunohistochemical characteristics.