Papers of the Week

Inflammatory fibroid polyp (IFP) is a rare clinically benign mesenchymal tumor originating in the submucosa of the gastrointestinal tract. It has been generally considered to bear no malignant or metastatic potential and can be cured after resection. Herein, we present an unusual case of an IFP in the ileum showing extension to the muscularis propria and recurring in 3 years after endoscopic submucosal dissection (ESD) and surgical resection. A 41-year-old woman was admitted to the emergency department due to abdominal pain, abdominal distention, and vomit for 4 days. She had an ESD 3 years ago as a result of IFPs in the middle esophagus and gastric horn. She also had a small bowel resection for intussusception resulting from IFP 2 years previously. She had no family history of IFP. An intussusception was found 1 m away from the ileocecal valve and a red tumor about 5 cm in diameter was revealed after manipulation reduction, with several small polypoid protuberant masses in the adjacent intestine. The diseased bowel was excised and a primary side-to-side anastomosis was performed. The morphological and immunoprofile features were typical of IFP. The patient was required to fast after operation until she farted, and she was discharged 1 week later, asymptomatic. Therefore, IFP might show its aggressively neoplastic potential with infiltrative growth patterns and recur locally after inadequate resection. A sufficient surgical resection is recommended when the lesion has been found definitely to invade the muscularis and even the subserosa. However, more studies are required to seek for the exact etiology and mechanism of its invasiveness and recurrence due to the scarcity of current reports.