Gastric inflammatory myofibroblastic tumor masquerading as a pancreatic cystic neoplasm.

tric pain since 2 weeks. Esophagogastroduodenoscopy (EGD) revealed a 3-cm submucosal mass in the posterior wall of the gastric body. Abdominal ultrasound showed a multilocular cystic lesion (10 × 6 × 9 cm) in the pancreatic tail. Endoscopic ultrasound (EUS) confirmed a multicystic lesion arising from the pancreas (●" Fig. 1). The cysts were macrocystic in nature, ranging from 1 cm to 2 cm in size, and were intermixed with solid tumor. There was no evidence of internal calcifications or connection to the pancreatic duct. The EUS features were suggestive of a mucinous cystadenocarcinoma of the pancreas. However, a subsequent computed tomography scan revealed that the multilocular lesion was arising from the posterior wall of the stomach; this was confirmed on laparotomy (●" Fig. 2). Macroscopically, the tumor was a lobulated, circumscribed mass with amix of solid and cystic components (●" Fig. 3). Histologically, it consisted of proliferating spindle cells in a fibromyxoid stroma, admixed with a moderate amount of mixed inflammatory cellular infiltrate, compatible with a gastric inflammatorymyofibroblastic tumor (IMT). IMTs are rare neoplasms in adults. Microscopically, they are composed of spindle cells with abundant cytoplasm on an inflammatory background [1]. The diagnosis of IMT is often difficult and there are scarce reports of the EUS appearances. A well-defined hypoechoic mass arising from the submucosa, similar to gastrointestinal stromal tumors, has been described [2,3]. However, a multilocular cystic appearance along with solid components has not been previously documented in the literature. In the present case, the lesion was initially mistaken to be a pancreatic cystic neoplasm and a retGastric inflammatory myofibroblastic tumor masquerading as a pancreatic cystic neoplasm