Fetal and Pediatric Pathology, 26:243–254, 2007 Copyright C  Informa Healthcare USA, Inc. ISSN: 1551-3815 print / 1551-3823 online DOI: 10.1080/15513810801893421 INFLAMMATORY MYOFIBROBLASTIC TUMOR OF THE MIDESOPHAGUS Steven B. Goldin, Dana Osborne, Charles Paidas, Justin Iannello, Enid Gilbert-Barness, and Richard Karl ✷ Department of Surgery, University of South Florida College of Medicine, Tampa, Florida, USA Michael J. Wilsey, Jr. ✷ University of South Florida College of Medicine and Pediatric Gastroenterology, Hepatology, and Nutrition of Florida, All Children’s Hospital, St. Petersburg, Florida, USA ✷ An inflammatory myofibroblastic tumor (IMFT) is a rare entity that can arise in a multiplicity of organs including the lung, liver, and at any location within the gastrointestinal tract. Typically, an IMFT presents as a localized mass with clinical symptoms dependent upon its site of origin. IMFTs pathologically resemble a neoplastic process but are theorized to arise from an unknown inflammatory event. We present a case of a midesophageal IMFT in a 12-year-old female. Keywords myofibroblastic, esophagus, Epstein-Barr, pseudotumor, spindle cell CASE REPORT A 12 year-old, Caucasian female with a remote history of asthma, mononucleosis, and shingles had progressive development of substernal chest pain, dysphagia, and a globus sensation starting approximately 13 months prior to presenting to her pediatrician. She had been experiencing frequent bouts of postprandial emesis of undigested food and was started on proton pump inhibitor (PPI) therapy with which she was compliant. Then, 72 hrs after initiation of PPI therapy, she presented to a local emergency department with an acute exacerbation of her chest pain and the onset of upper abdominal pain that began approximately 1 week after a bout of a diarrheal illness. At presentation, she was profoundly hypernatremic with a serum sodium of 168 MEQ/L and a chloride of 128 MEQ/L. The remaining laboratory values were within normal limits. She was admitted to the pediatric service for management and further evaluation. Address correspondence to Steven B. Goldin, MD, PhD, Digestive Disorders Center, Tampa General Hospital, 1 Davis Island, F-145, Tampa, FL 33601, USA. E-mail: sgoldin@hsc.usf.edu 243