From "suspected appendicitis" to definitive diagnosis: the role of contrast-enhanced ultrasound-guided biopsy in a rare case of colonic inflammatory myofibroblastic tumor in an adolescent.

Source: PubMed, NCBI / U.S. National Library of Medicine

Inflammatory myofibroblastic tumor (IMT) of the colon is a rare mesenchymal neoplasm of intermediate biological potential that can mimic acute appendicitis in adolescents. We report a 13-year-old male presenting with right lower quadrant pain and fever. Initial ultrasound revealed a large heterogeneous hypoechoic mass. Contrast-enhanced ultrasound (CEUS) clearly differentiated a peripherally enhancing viable rim from a central necrotic area, enabling precise ultrasound-guided core needle biopsy that yielded a definitive preoperative diagnosis of IMT. The patient underwent laparoscopic right hemicolectomy with negative margins and had an uneventful recovery. This case illustrates that a systematic CEUS-guided biopsy approach is safe and accurate, allowing targeted sampling of viable tissue and guiding appropriate surgical resection. Recognizing the diagnostic value of CEUS in complex pediatric abdominal masses may help avoid misdiagnosis and unnecessary extensive surgery.