![]() Ĭlinical presentation depends on size and location generally. They can be sessile or pedunculated and usually contain blood vessels, fibroblasts, and an edematous stroma rich in eosinophils. Colonic IFPs are exceedingly rare and most commonly located in proximal colon, especially in the caecum. IFPs are found mostly in the stomach (70%) and the small intestine (20%). Regarded by many as reactive tumours of nonneoplastic origin until 2008, the neoplastic nature of IFPs became evident after the detection of activating PDGFRA mutations. With newer advancements in endoscopic surgery, these are now treatable with less invasive procedures except when the presentation is that of an acute abdomen. Ranging from few millimeters to several centimeters (giant > 4 cm), these often clinically mimic malignancy and are treated radically. Also referred to as Vanek’s tumour, these tumours do not have a specific age or gender predilection. IFPs are rare benign mesenchymal gastrointestinal tumours. At one-year follow-up, she remained symptom-free. The patient had an uneventful recovery and was discharged on the 10th postoperative day. Immunohistochemical staining was found negative for CD34, CK PAN, and CD117 as shown in Figures 3(b) and 3(c) and hence the diagnosis of IFP was confirmed. (c) Immunohistochemical staining negative for CD117. ![]() (b) Immunohistochemical staining negative for CD34. (a) Microscopic appearance of IFP (Eosin/Hematoxylin stain). Right hemicolectomy with ileotransverse anastomosis was performed. At laparotomy, a mass measuring 8 × 7 × 5 cm arising from the hepatic flexure of colon was noted as shown in Figure 1. At diagnostic laparoscopy purulent and fibrinous reaction in the subhepatic region was noted based on which decision to proceed further was made. With differential diagnoses of ruptured hydatid cyst, duodenal ulcer perforation, acute acalculous cholecystitis, and an ulcerated GIST (Gastrointestinal Stromal Tumour) an emergency diagnostic laparoscopy followed by midline laparotomy was performed. In view of patient’s general condition and lack of facilities, CT scan and Colonoscopy could not be done. Abdominal sonography revealed a double walled solid mass in the right upper abdomen very close to the liver and bilateral ovarian cysts. Hematological and biochemical tests were normal. Physical examination revealed a tender and guarded right upper abdomen. Case PresentationĪ 36-year-old female with no previous illness presented with an acute onset pain over the right hypochondrium for 3 days associated with intermittent fever and anorexia. The rarities of this case are the atypical site of its occurrence and acuteness of its presentation. ![]() Its clinical presentation, investigative findings, and management are discussed and relevant literatures are reviewed. We report an interesting, rare case of IFP of the hepatic flexure of colon in an adult female. The presentation of IFP varies and because of its rarity the correct preoperative diagnosis is often difficult and delayed. The etiology and pathogenesis are not well known. The term Inflammatory Fibroid Polyp was introduced by Helwig and Ranier in 1953. In 1949, Vanek made a report of 6 cases of gastric lesions which he referred to as gastric submucosal granuloma with eosinophilic infiltration. The first case of IFP was described by Konjetzny in 1920 as “Polypoid Fibroma”. Surgical resection has been the most common method of treatment especially for large and giant colonic IFPs owing to challenges in terms of diagnosis and technical difficulties associated with endoscopic methods. ![]() Definitive diagnosis is possible with histopathological examination of tissue aided by immunohistochemical studies. IFP is a very rare condition with clinical presentation depending upon its size and location. The mass was subsequently reported to be IFP. A mass measuring 8 × 7 × 5 cm arising from the hepatic flexure of colon was noted. As she had evidence of localized peritonitis she underwent a diagnostic laparoscopy and subsequently an exploratory laparotomy. A 36-year-old female with no previous illness presented to the emergency unit with an acute onset pain over the right hypochondrium for 3 days associated with intermittent fever and anorexia. Since 1952 till now only 32 cases have been reported worldwide of which only 5 were giant (>4 cm) polyps mostly found in the caecum (15 cases) with only 3 in the descending colon. Inflammatory Fibroid Polyp (IFP) of the colon is an exceedingly rare condition.
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