101
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Jiang JY, Comsa M, Wong VCK, Mansberg R. Steroid responsive inflammatory myofibroblastic tumor of the lung evaluated by FDG PET/CT imaging. Radiol Case Rep 2022; 17:907-910. [PMID: 35069958 PMCID: PMC8762374 DOI: 10.1016/j.radcr.2021.11.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 11/21/2021] [Indexed: 11/28/2022] Open
Abstract
A 68-year-old gentleman was referred for 18F-FDG PET/CT for a pulmonary mass in the left upper lobe which demonstrated intensely FDG-avid confluent pulmonary consolidation in the left upper lobe (SUVmax 15.1). Histopathologic biopsy of the left upper lobe lung mass was consistent with inflammatory myofibroblastic tumor (IMT). The patient was started on steroid treatment in conjunction with antibiotics. Follow-up FDG PET/CT 3 weeks after commence of treatment showed remarkable response of the IMTs to therapy with much less avid FDG uptake (SUVmax 5.4) and marked improvement in the pulmonary consolidation. Nevertheless, the patient underwent left upper lobe lobectomy due to evidence of persistent cystic disease and malignant potential associated with IMTs. Final histopathology was consistent with IMT with no evidence of malignancy.
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Affiliation(s)
- James Yuheng Jiang
- Departments of Nuclear Medicine and PET, Nepean Hospital, Kingswood, Derby St, NSW 2747, Australia
- Corresponding author.
| | - Monica Comsa
- Department of Respiratory Medicine, Nepean Hospital, Kingswood, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Veronica Chi Ken Wong
- Departments of Nuclear Medicine and PET, Nepean Hospital, Kingswood, Derby St, NSW 2747, Australia
- Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Robert Mansberg
- Departments of Nuclear Medicine and PET, Nepean Hospital, Kingswood, Derby St, NSW 2747, Australia
- Faculty of Medicine and Health, University of Sydney, NSW, Australia
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102
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Gupta RR, Trinh M, Mechel E, Rodgers R, Kodsi S, Schwartzstein H, Hymowitz M, Williamson AK. Inflammatory Myofibroblastic Tumor of the Orbit in a 5-Month-Old Infant. J Pediatr Ophthalmol Strabismus 2022; 59:e25-e28. [PMID: 35343820 DOI: 10.3928/01913913-20220124-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Inflammatory myofibroblastic tumors are mesenchymal neoplasms composed of spindle cells and inflammatory infiltrate. The authors describe a 5-month-old infant with orbital inflammatory myofibroblastic tumor, the youngest patient currently reported in the literature. The histo-pathology, orbital apex location, and patient's age led to a chemotherapy-driven treatment using crizotinib with near-complete resolution of the tumor. [J Pediatr Ophthalmol Strabismus. 2022;59(2):e25-e28.].
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103
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Han Q, He X, Cui L, Qiu Y, Li Y, Chen H, Zhang H. Case Report: Early Distant Metastatic Inflammatory Myofibroblastic Tumor Harboring EML4-ALK Fusion Gene: Study of Two Typical Cases and Review of Literature. Front Med (Lausanne) 2022; 9:826705. [PMID: 35280868 PMCID: PMC8907662 DOI: 10.3389/fmed.2022.826705] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a distinctive neoplasm that frequently arises in the lung and accounts for ~1% of lung tumors. Distant metastatic IMT is extremely rare and has been poorly investigated. This analysis was specifically performed to explore the clinicopathological and genetic features of early distant metastatic IMT. Two typical patients with distant metastatic IMTs were selected, which accounted for 1.13% of all diagnosed IMTs in the last 5 years. One patient was a 55 year-old male, and the other patient was a 56 year-old female. Both primary tumors arose from the lung, and the initial clinical symptoms of the two patients involved coughing. Both of the imaging examinations showed low-density nodular shadows in the lungs with enhancement around the mass. Microscopically, dense arranged tumor cells, prominent cellular atypia, and high mitotic activity with atypical form were more prominent in the metastatic lesions than in the primary lesions. All of the primary and metastatic tumors in both cases showed positive anaplastic lymphoma kinase (ALK) immunostaining and ALK rearrangement via fluorescence in situ hybridization. The EML4 (exon 6)-ALK (exon 20) fusion variant (v3a/b) was identified by using next-generation sequencing (NGS) and was verified by using reverse transcription polymerase chain reaction (RT-PCR). Furthermore, intronic variants of NOTCH1 and synonymous variants of ARAF were also detected via NGS in one IMT for the first time and were verified in all of the primary and metastatic lesions via PCR. Distant metastasis occurred during a short period of time (1 and 2 months) after the first surgery. One patient presented with multiple metastases to the subcutaneous tissue and bone that responded to ALK inhibitor alectinib therapy, and the tumor was observed to regress 10 months after the initial ALK inhibitor therapy. In contrast, the other patient presented with subcutaneous neck metastasis without ALK inhibitor treatment and succumbed to the disease within 3 months after the surgery. This study demonstrated the possible role of EML4-ALKv3a/b in the malignant progression of IMT and proposed certain therapeutic effects of ALK inhibitors on multiple metastatic IMTs.
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Affiliation(s)
- Qianqian Han
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Xin He
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Lijuan Cui
- Department of Pathology, Suining Central Hospital, Suining, China
| | - Yan Qiu
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuli Li
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Huijiao Chen
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
| | - Hongying Zhang
- Department of Pathology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Hongying Zhang
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104
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Rakheja D, Park JY, Fernandes NJ, Watt TC, Laetsch TW, Collins RRJ. Pediatric Non-Myofibroblastic Primitive Spindle Cell Tumors with ALK Gene Rearrangements and Response to Crizotinib. Int J Surg Pathol 2022; 30:706-715. [PMID: 35164578 DOI: 10.1177/10668969221080072] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We describe two poorly differentiated, non-myofibroblastic (SMA-, S100+, CD34±), spindle cell neoplasms with immunohistochemical positivity for ALK and with ALK gene rearrangements leading to PLEKHH2::ALK and CLTC::ALK fusions, respectively. ALK protein overexpression and/or gene fusions should be evaluated in poorly differentiated spindle cell neoplasms, even when there is an absence of a myofibroblastic phenotype. A positive ALK evaluation has therapeutic implications as both tumors responded to single-agent treatment with the tyrosine kinase inhibitor crizotinib.
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Affiliation(s)
- Dinesh Rakheja
- Department of Pathology, 12334University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Dallas, TX, USA
| | - Jason Y Park
- Department of Pathology, 12334University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Dallas, TX, USA
| | - Neil J Fernandes
- Children's Health, Dallas, TX, USA.,Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tanya C Watt
- Children's Health, Dallas, TX, USA.,Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Theodore W Laetsch
- Division of Oncology, 6567Children's Hospital of Philadelphia and Perelman School of Medicine and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Rebecca R J Collins
- Department of Pathology, 12334University of Texas Southwestern Medical Center, Dallas, TX, USA.,Children's Health, Dallas, TX, USA
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105
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Zhu T, Gao P, Gao J, Liu X, Zhang X. A huge recurrent retroperitoneal inflammatory myofibroblastic tumor implicating renal and ureter: a case report. Transl Cancer Res 2022; 10:4565-4570. [PMID: 35116312 PMCID: PMC8798890 DOI: 10.21037/tcr-21-899] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/30/2021] [Indexed: 12/05/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare sarcoma with unique molecular characteristics. It also has typical fasciitis-like, dense spindle cells and hypocellular fibrous histologic patterns and can occur at any age. The etiology of IMT is unknown and a complete treatment and monitoring plan for IMT have not been developed. We have found a rare case about a huge recurrent IMT implicating renal and ureter. The patient was accompanied by a history of a lesion sized 15.5 cm × 11.5 cm × 10.5 cm as a retroperitoneal IMT, and the first tumor resection was performed 12 months ago. The patient, who suffered from tumor recurrence within 1 year and whose recurrent tumor also invaded into the renal parenchymal was given a retroperitoneal neoplasm resection plus right nephrectomy. In order to clarify the pathological features, the histological specimens of recurrent retroperitoneal IMT were examined as well as primary retroperitoneal IMT, and immunohistochemical (IHC) stains showed that the spindle cells were positive for vimentin and negative for anaplastic lymphoma kinase (ALK). At 24 months follow-up, the patient recovered well and there was no evidence of tumor recurrence. This case report is conducive to understanding this rare tumor. When conditions permit, complete surgical resection is the recommended treatment for primary and recurrent IMT.
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Affiliation(s)
- Tianle Zhu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Pan Gao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jingjing Gao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xi Liu
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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106
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Couper MR, Eldredge JA, Kirby M, Kirby C, Moore D, Hammond P, Manton N, Glynn A, Couper RT. Paediatric Gastrointestinal, Hepatic and Pancreatic Inflammatory Myofibroblastic Tumours, A Single Centre Experience. J Pediatr Gastroenterol Nutr 2022; 74:253-257. [PMID: 34596604 DOI: 10.1097/mpg.0000000000003311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
ABSTRACT Inflammatory myofibroblastic tumours (IMTs) are rare soft tissue tumours. Reports of gastrointestinal tract, liver and pancreas tumours are limited. The objective of this study is to identify presenting features, contributing prognostic / etiological factors and any variability in outcomes in the context of different historical treatments. We retrospectively reviewed the records of seven children treated at our hospital between 2006 and 2019 and assessed the demographic, presentation, treatment, immunohistochemistry, and outcomes of their tumours. Age range at presentation was 4 months-15 years with a male predominance. Presentations were typically due to local mass effect or incidental discovery. Systemic symptoms were rare. Outcomes were good with six out of seven stable or in remission irrespective of treatment. Surgical resection where possible is the treatment of choice. Medical therapy had good outcomes with chemotherapy acting as first line treatment when required. The only negative prognostic factor identified was local spread at the time of presentation.
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107
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Liu J, Bai Z, Li S, Zeng S, Li C, Liu Q. Case Report: Recurrence of Testicular Myofibroblastic Tumor After Surgery. Front Oncol 2022; 11:810708. [PMID: 35096616 PMCID: PMC8795764 DOI: 10.3389/fonc.2021.810708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Inflammatory myofibroblastic tumour (IMT), also known as plasma cell granuloma (PCG) or inflammatory pseudotumour (IPT), is a distinctive, rarely metastasizing neoplasm composed of myofibroblastic and fibroblastic spindle cells accompanied by inflammatory infiltration of plasma cells, lymphocytes and/or eosinophils. IMT predominantly affects children and young adults, and the age at presentation ranges from 3 to 89 years. We present a very rare case of recurrent testicular IMT without ALK rearrangement. This case highlights the clinical characteristics and diagnostic factors associated with primary and recurrent foci of this rare tumour, along with key therapeutic approaches.
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Affiliation(s)
- Jiayi Liu
- The First Central Clinical College of Tianjin Medical University, Tianjin, China.,Department of Urology, Tianjin First Central Hospital, School of Medicine, NanKai University, Tianjin, China
| | - Zhijie Bai
- Department of Urology, Tianjin First Central Hospital, School of Medicine, NanKai University, Tianjin, China
| | - Shuaiqi Li
- School of Medicine, Nankai University, Tianjin, China
| | - Sheng Zeng
- Department of Urology, Tianjin First Central Hospital, School of Medicine, NanKai University, Tianjin, China
| | - Chuang Li
- Department of Urology, Tianjin First Central Hospital, School of Medicine, NanKai University, Tianjin, China
| | - Qian Liu
- Department of Urology, Tianjin First Central Hospital, School of Medicine, NanKai University, Tianjin, China
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108
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Siddiqui D, Tukruna A, Afzal SS, Tebha SS, Yusuf FH. "Inflammatory myofibroblastic tumor of the maxillary sinus: A case report". EAR, NOSE & THROAT JOURNAL 2022:1455613221075233. [PMID: 35098769 DOI: 10.1177/01455613221075233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) are one of the most complex and rare neoplasms that have been discovered, with varying behavior in different cases. They mostly arise in the thoracic and abdominal cavity, the lungs, retroperitoneum, and extremities. They can also be detected in the head and neck area. IMTs have no age or gender preference which makes them tougher to anticipate. Head and neck IMTs are benign neoplasms with locally aggressive behavior and a low risk of metastatic spread. They have an unknown etiology, and they resemble malignant lesions radiologically. In this case report, we will review the case of a 40-year-old woman with an unusual IMT in the maxillary sinus that presented as a challenge in diagnosis and management.
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Affiliation(s)
- Dua Siddiqui
- Department of Medicine, 72597Liaquat National Medical College, Karachi, Pakistan
| | - Alaa Tukruna
- Department of Medicine, 204586Batterjee Medical College, Jeddah, Saudi Arabia
| | | | - Sameer Saleem Tebha
- Department of Neurosurgery and Neurology, 66812Jinnah Medical and Dental College, Karachi, Pakistan
| | - Farah Hafiz Yusuf
- Department of Otolaryngology, 66816Dow Medical College, Karachi, Pakistan
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109
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Yao Q, Bai Q, Zhang X, Ji G, Chang H, Cai X, Yu L, Wang J, Zhu X, Zhou X. Assessment of ALK Fusions in Uncommon Inflammatory Myofibroblastic Tumors With ALK IHC Positivity but FISH-Equivocal Findings by Targeted RNA Sequencing. Arch Pathol Lab Med 2022; 146:1234-1242. [PMID: 35041745 DOI: 10.5858/arpa.2021-0230-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) are common methods to detect ALK status in inflammatory myofibroblastic tumors (IMTs). However, equivocal ALK FISH signals and inconsistency between FISH and IHC are occasionally observed. OBJECTIVE.— To study the inconsistency between FISH and IHC, and clarify ALK status in IMT by targeted RNA sequencing (RNAseq). DESIGN.— In this study, 12 consultation cases preliminarily diagnosed as uncommon IMTs with ALK IHC positivity but FISH negativity, plus 3 ALK-positive and 3 ALK-negative IMTs, were re-analyzed by IHC, FISH, and RNAseq. RESULTS.— As a result, 1 case with FUS-TFCP2 fusion was detected by RNAseq, which was previously misdiagnosed as IMT. In the other 11 uncommon IMTs, 90.9% (10 of 11) showed equivocal ALK FISH signals, and all were confirmed to harbor ALK fusion by RNAseq, except for 1 failure, suggesting that a low threshold for ALK FISH might be proposed in IMT. Furthermore, RNAseq also identified IGFBP5-ALK in 1 case with ALK IHC positivity but typical FISH negativity, suggesting the possibility of false negatives for ALK FISH. For the typical IMTs, ALK fusion was identified by RNAseq in all 3 ALK-positive IMTs as expected, and additionally FN1-ROS1 fusions were identified in 2 of 3 ALK-negative IMTs. CONCLUSIONS.— These findings indicated that RNAseq can simultaneously detect multiple gene fusions and provide fusion forms and breakpoints, which is of great value for differential diagnosis, especially for those uncommon IMTs with equivocal FISH findings, or inconsistency between IHC and FISH.
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Affiliation(s)
- Qianlan Yao
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Qianming Bai
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Xin Zhang
- Department of Pathology, Fudan University, Zhongshan Hospital, Shanghai, China (Zhang)
| | - Gang Ji
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Heng Chang
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Xu Cai
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Lin Yu
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Jian Wang
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Xiaoli Zhu
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Xiaoyan Zhou
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
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110
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Zarrouki S, Marouf R. Mini-invasive endoscopic approach to tracheal inflammatory myofibroblastic tumor in a young woman: A case report. Ann Med Surg (Lond) 2022; 73:103208. [PMID: 35070283 PMCID: PMC8767228 DOI: 10.1016/j.amsu.2021.103208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/19/2021] [Accepted: 12/19/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Inflammatory myofibroblastic tumor (IMT) of the trachea is rare tumor mostly found in children and young adults. CASE REPORT We report a case of a 28 year-old woman who presented chronic isolated coughing. Chest CT scan showed a tracheal tumor. Rigid bronchoscopy allowed the complete removal of the tumor, and histology confirmed the diagnosis of IMT. 12 months follow-up found no recurrence. DISCUSSION IMT is a rare tumor exhibiting both benign and aggressive behaviour. The endoscopic approach of tracheal should be considered when there is a minimal tracheal wall invasion. CONCLUSION Through this case, we want to emphasise the role of rigid bronchoscopy in the complete removal of endotracheal IMT.
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Affiliation(s)
- Sara Zarrouki
- Thoracic Surgery Departement, Mohammed VI University Hospital Center, Oujda, Morocco
- Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Rachid Marouf
- Thoracic Surgery Departement, Mohammed VI University Hospital Center, Oujda, Morocco
- Mohammed First University, Faculty of Medicine and Pharmacy, Oujda, Morocco
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111
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Boriçi S, Tanka M, Serbo L. Inflammatory myofibroblastic tumour of the lung: Case report and review of the literature. Respirol Case Rep 2022; 10:e0885. [PMID: 34934506 PMCID: PMC8652042 DOI: 10.1002/rcr2.885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
Inflammatory myofibroblastic tumour (IMT) of the lung is a rare tumour encountered in children. Although it is seen mostly in paediatric ages, a small number of cases exists in the literature. It may appear as an inflammatory mass or may have the characteristics of a tumour with the ability for recidivism and metastasis. Careful follow-up of the cases is required to differentiate between the two. We present the case of a 4-year-old girl who presented with cough, and the chest x-ray and computed tomography scan revealed a tumour mass in the right lung. After lobectomy, histological examination combined with immunohistochemical study discovered an IMT of the lung.
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Affiliation(s)
- Sonila Boriçi
- Service of Pulmonology and AllergyUniversity Hospital Center “Mother Tereza”TiranaAlbania
| | - Marjeta Tanka
- Service of Pulmonology and AllergyUniversity Hospital Center “Mother Tereza”TiranaAlbania
| | - Luljeta Serbo
- Service of Pulmonology and AllergyUniversity Hospital Center “Mother Tereza”TiranaAlbania
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112
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Demir Ö, Onal O. Surgical treatment outcomes of pulmonary inflammatory myofibroblastic tumors. Ann Thorac Med 2022; 17:44-50. [PMID: 35198048 PMCID: PMC8809124 DOI: 10.4103/atm.atm_119_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/25/2021] [Accepted: 07/03/2021] [Indexed: 11/04/2022] Open
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113
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Boyraz B, Hung YP. Spindle Cell Tumors of the Pleura and the Peritoneum: Pathologic Diagnosis and Updates. APMIS 2021; 130:140-154. [PMID: 34942046 DOI: 10.1111/apm.13203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 09/23/2021] [Indexed: 11/30/2022]
Abstract
A diverse group of both benign and malignant spindle cell tumors can involve the pleura or the peritoneum. Due to their rarity and overlapping morphologic features, these tumors can pose considerable diagnostic difficulty in surgical pathology. As these tumors differ in their prognosis and clinical management, their correct pathologic diagnosis is critical. In addition to histologic assessment, select immunohistochemical and molecular tools can aid the distinction among these tumors. In this review, we consider some of the major histologic differential diagnosis of spindle cell tumors involving these serosal membranes. This list of tumors includes: solitary fibrous tumor, inflammatory myofibroblastic tumor, desmoid fibromatosis, synovial sarcoma, sarcomatoid carcinoma, spindle cell melanoma, dedifferentiated liposarcoma, epithelioid hemangioendothelioma, and sarcomatoid mesothelioma. We describe their salient clinicopathologic and genetic findings, with a review on some of the recent discoveries on their molecular pathogenesis.
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Affiliation(s)
- Baris Boyraz
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Yin P Hung
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
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114
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Wu S, Jian F. A Case Report of Inflammatory Myofibroblastic Tumor of the Sphenoidal Sinus. EAR, NOSE & THROAT JOURNAL 2021:1455613211065990. [PMID: 34933588 DOI: 10.1177/01455613211065990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a tumor composed of differentiated myofibroblastic spindle-shaped cells. It occurs in the soft tissues of the abdomen and lungs, and is very rare in the sphenoid sinus. The diagnosis depends on histopathology and immunohistochemistry, and is easily misdiagnosed. Although metastasis is rare, the recurrence rate is high. Surgical resection is the treatment of choice, and where complete resection is difficult, radiation therapy, hormonal therapy, or molecular targeted drug therapy can be administered. We report a rare case of IMT with a primary origin in the sphenoid sinus, which was entirely resected by nasal endoscopy and confirmed by histological examination.
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Affiliation(s)
- Shuo Wu
- Department of E.N.T., the 3rd affiliated hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Feitong Jian
- Department of E.N.T., the 3rd affiliated hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
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115
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Craig E, Wiltsie LM, Beaupin LK, Baig A, Kozielski R, Rothstein DH, Li V, Twist CJ, Barth M. Anaplastic lymphoma kinase inhibitor therapy in the treatment of inflammatory myofibroblastic tumors in pediatric patients: Case reports and literature review. J Pediatr Surg 2021; 56:2364-2371. [PMID: 33676744 DOI: 10.1016/j.jpedsurg.2021.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/21/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Inflammatory myofibroblastic tumors (IMTs) are a rare subtype of inflammatory pseudotumor frequently associated with rearrangement of the anaplastic lymphoma kinase (ALK) gene. Their treatment has historically relied on at-times challenging and morbid surgical excision. Recent studies have shown that neo/adjuvant therapy with ALK inhibitors can significantly enhance outcomes in select patients. METHODS A systematic literature review was performed to characterize comprehensive treatment of ALK-positive IMTs in the pediatric population. This report also includes two patients from our home institutions not previously reported in the literature. RESULTS We identified a total of 27 patients in 12 studies in addition to 2 patients from the senior authors' institution for a total of 29 patients (median age, 7 years; 52% male). The IMTs comprised a wide range of anatomic locations. Almost half (12, 41.3%) were treated with ALK-inhibitors alone and felt to be in remission. The remainder was treated with ALK-inhibitors either before or after surgery and had a curative response. CONCLUSIONS ALK-positive IMTs can be successfully treated with ALK-inhibition alone or in combination with surgical resection. Further genetic characterization may be helpful in determining more precise treatment and defining needed durations thereof.
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Affiliation(s)
- Ethan Craig
- Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States
| | - Laura M Wiltsie
- Division of Pediatric Hematology/Oncology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States
| | - Lynda K Beaupin
- Division of Pediatric Hematology/Oncology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences and Department of Pediatrics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Ayesha Baig
- Division of Pediatric Gastroenterology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States
| | - Rafal Kozielski
- Department of Pathology, John R. Oishei Children's Hospital, Buffalo, NY, United States
| | - David H Rothstein
- Department of Pediatric Surgery John R. Oishei Children's Hospital and Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States.
| | - Veetai Li
- Department of Pediatric Neurosurgery, John R. Oishei Children's Hospital and Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, United States
| | - Clare J Twist
- Division of Pediatric Hematology/Oncology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences and Department of Pediatrics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Matthew Barth
- Division of Pediatric Hematology/Oncology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences and Department of Pediatrics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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Kerr DA, Thompson LDR, Tafe LJ, Jo VY, Neyaz A, Divakar P, Paydarfar JA, Pastel DA, Shirai K, John I, Seethala RR, Salgado CM, Deshpande V, Bridge JA, Kashofer K, Brčić I, Linos K. Clinicopathologic and Genomic Characterization of Inflammatory Myofibroblastic Tumors of the Head and Neck: Highlighting a Novel Fusion and Potential Diagnostic Pitfall. Am J Surg Pathol 2021; 45:1707-1719. [PMID: 34001695 DOI: 10.1097/pas.0000000000001735] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a distinctive fibroblastic and myofibroblastic spindle cell neoplasm with an accompanying inflammatory cell infiltrate and frequent receptor tyrosine kinase activation at the molecular level. The tumor may recur and rarely metastasizes. IMT is rare in the head and neck region, and limited information is available about its clinicopathologic and molecular characteristics in these subsites. Therefore, we analyzed a cohort of head and neck IMTs through a multi-institutional approach. Fourteen cases were included in the provisional cohort, but 1 was excluded after molecular analysis prompted reclassification. Patients in the final cohort included 7 males and 6 females, with a mean age of 26.5 years. Tumors were located in the larynx (n=7), oral cavity (n=3), pharynx (n=2), and mastoid (n=1). Histologically, all tumors showed neoplastic spindle cells in storiform to fascicular patterns with associated chronic inflammation, but the morphologic spectrum was wide, as is characteristic of IMT in other sites. An underlying fusion gene event was identified in 92% (n=11/12) of cases and an additional case was ALK-positive by IHC but could not be evaluated molecularly. ALK represented the driver in all but 1 case. Rearrangement of ALK, fused with the TIMP3 gene (n=6) was most commonly detected, followed by 1 case each of the following fusion gene partnerships: TPM3-ALK, KIF5B-ALK, CARS-ALK, THBS1-ALK, and a novel alteration, SLC12A2-ROS1. The excluded case was reclassified as spindle cell rhabdomyosarcoma after detection of a FUS-TFCP2 rearrangement and retrospective immunohistochemical confirmation of rhabdomyoblastic differentiation, illustrating an important diagnostic pitfall. Two IMT patients received targeted therapy with crizotinib, with a demonstrated radiographic response. One tumor recurred but none metastasized. These results add to the growing body of evidence that kinase fusions can be identified in the majority of IMTs and that molecular analysis can lead to increased diagnostic accuracy and broadened therapeutic options for patients.
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Affiliation(s)
- Darcy A Kerr
- Departments of Pathology and Laboratory Medicine
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Lester D R Thompson
- Department of Pathology, Southern California Permanente Medical Group, Woodland Hills, CA
| | - Laura J Tafe
- Departments of Pathology and Laboratory Medicine
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School
| | - Azfar Neyaz
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | | | - Joseph A Paydarfar
- Section of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - David A Pastel
- Radiology
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Keisuke Shirai
- Medical Oncology
- Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Ivy John
- Department of Pathology, University of Pittsburgh
| | | | - Claudia M Salgado
- Department of Pathology, Children's Hospital of Pittsburgh, Pittsburgh, PA
| | - Vikram Deshpande
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Julia A Bridge
- Molecular Division, ProPath LLC, Dallas, TX
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE
| | - Karl Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Iva Brčić
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Konstantinos Linos
- Departments of Pathology and Laboratory Medicine
- Geisel School of Medicine at Dartmouth, Hanover, NH
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117
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Tan SY, Al-Ibraheemi A, Ahrens WA, Oesterheld JE, Fanburg-Smith JC, Liu YJ, Spunt SL, Rudzinski ER, Coffin C, Davis JL. ALK rearrangements in infantile fibrosarcoma-like spindle cell tumours of soft tissue and kidney. Histopathology 2021; 80:698-707. [PMID: 34843129 DOI: 10.1111/his.14603] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 12/11/2022]
Abstract
AIMS Recurrent alterations in receptor tyrosine kinase (RTK) and downstream effectors are described in infantile fibrosarcoma (IFS)/cellular congenital mesoblastic nephroma (cCMN) and a subset of spindle cell sarcomas, provisionally designated 'NTRK-rearranged' spindle cell neoplasms. These two groups of tumours demonstrate overlapping morphologies and harbour alterations in NTRK1/2/3, RET, MET, ABL1, ROS1, RAF1 and BRAF, although their relationship is not fully elucidated. We describe herein a cohort of paediatric tumours with clinicopathological features not typical for inflammatory myofibroblastic tumour, but rather with similarities to cCMN/IFS harbouring ALK fusions. METHODS AND RESULTS Clinicopathological features were assessed and partner agnostic targeted RNA sequencing on clinically validated platforms were performed. Tumours occurred in patients aged from 2 to 10 years (median age 2 years) with a 2:2 male to female ratio and an average size of 8.4 cm. Two tumours arose in soft tissues and two in the kidney. Morphological features included spindle to ovoid cells arranged in long fascicles or haphazardly within a myxoid to collagenised stroma; a subset of cases had either dilated, ectatic vessels or focal perivascular hyalinosis. By immunohistochemistry, all cases tested showed cytoplasmic expression of anaplastic lymphoma kinase (ALK) and one case demonstrated co-expression of CD34 and S100. CONCLUSIONS This series of ALK-rearranged IFS-like tumours expands the spectrum of targetable kinases altered in these tumours and reinforces the potential overlap between IFS/cCMN-like tumours and the provisional entity of 'NTRK-rearranged' spindle cell neoplasms.
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Affiliation(s)
- Serena Y Tan
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Alyaa Al-Ibraheemi
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Javier E Oesterheld
- Department of Pediatrics, Levine Children's Hospital, Atrium Health, Charlotte, NC, USA
| | - Julie C Fanburg-Smith
- Department of Pathology, Pediatrics and Orthopedics, PennState Health, Penn State Children's Hospital, Penn State College of Medicine, Hershey, PA, USA
| | - Yajuan J Liu
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USA
| | - Sheri L Spunt
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Erin R Rudzinski
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA, USA
| | - Cheryl Coffin
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA
| | - Jessica L Davis
- Department of Pathology, Oregon Health & Sciences University, Portland, OR, USA
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118
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López de Sa A, Pascual A, Garcia Santos J, Mendez R, Bellon M, Ramirez M, Matute F, Del Arco C, Manzano A, Coronado P, Casado A, Marquina G. Inflammatory myofibroblastic tumour of an unusual presentation in the uterine cervix: a case report. World J Surg Oncol 2021; 19:331. [PMID: 34801049 PMCID: PMC8606074 DOI: 10.1186/s12957-021-02438-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background Inflammatory myofibroblastic tumour is an infrequent mesenchymal neoplasia of unknown aetiology and variable behaviour, ranging from rather benign lesions to locally aggressive and even metastatic disease. Its presence has been described in almost all organs; however, its location in the female genital tract has rarely been reported. Case presentation We present the case of a 47-year-old female, who was studied in our institution for a recent medical history of several weeks of dyspareunia and abdominal pain. She underwent pertinent studies including ultrasonography and CT scan. Under suspicion of degenerated leiomyoma, a total hysterectomy was performed. Unexpectedly, the pathological study of the surgical specimen showed very few tumour cells with focal fusiform morphology surrounded by an abundant inflammatory infiltrate; a thorough immunohistochemistry study lead to myofibroblastic tumour of the cervix diagnosis. A PET-CT scan did not show metastatic disease. The patient did not undergo any adjuvant treatment, and she is currently on surveillance with no evidence of disease relapse. Conclusions Inflammatory myofibroblastic tumour remains a rare entity yet to be fully elucidated. The diagnosis is based on pathological study due to the lack of typical clinical manifestations and typical radiological images. Surgical resection is the most frequent treatment, whereas chemotherapy and radiotherapy are restricted to locally advanced or metastatic disease. Tirosine kinase inhibitor crizotinib has shown promising results especially in tumours harbouring ALK mutation.
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Affiliation(s)
- Alfonso López de Sa
- Department of Medical Oncology, Hospital Clinico san Carlos, Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - Alejandro Pascual
- Department of Pathology, Hospital Universitario Clinico San Carlos, Madrid, Spain
| | - Javier Garcia Santos
- Gynaecologic Oncology Unit, Hospital Clinico san Carlos, Department of Obstetrics and Gynaecology, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - Ramiro Mendez
- Department of Radiology, Hospital Clinico san Carlos, Department of Radiology and Physics Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - Monica Bellon
- Gynaecologic Oncology Unit, Hospital Clinico san Carlos, Department of Obstetrics and Gynaecology, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - Mar Ramirez
- Gynaecologic Oncology Unit, Hospital Clinico san Carlos, Department of Obstetrics and Gynaecology, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - Fatima Matute
- Department of Radiology, Hospital Clinico san Carlos, Department of Radiology and Physics Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - Cristina Del Arco
- Department of Pathology, Hospital Universitario Clinico San Carlos, Madrid, Spain
| | - Aránzazu Manzano
- Department of Medical Oncology, Hospital Clinico san Carlos, Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - Pluvio Coronado
- Gynaecologic Oncology Unit, Hospital Clinico san Carlos, Department of Obstetrics and Gynaecology, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - Antonio Casado
- Department of Medical Oncology, Hospital Clinico san Carlos, Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain
| | - Gloria Marquina
- Department of Medical Oncology, Hospital Clinico san Carlos, Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), IdISSC, Madrid, Spain.
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119
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A Recurrent Inflammatory Myofibroblastic Tumor-like Lesion of the Splenic Capsule in a Kitten: Clinical, Microscopic and Ultrastructural Description. Vet Sci 2021; 8:vetsci8110275. [PMID: 34822648 PMCID: PMC8621069 DOI: 10.3390/vetsci8110275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe the findings of an unusual splenic tumor in a kitten. METHODS A grossly multinodular mass arising from the splenic capsule of a 7-month-old male Havana kitten was echographically detected and surgically removed by splenectomy, then analyzed microscopically and ultrastructurally. RESULTS The mass showed features of an inflammatory myofibroblastic tumor. TREATMENT AND OUTCOME Two months after surgical excision, the mass recurred in the same intra-abdominal area but disappeared after 2 months of anti-inflammatory therapy. Follow-up at 18 months after surgery revealed resolution of the disease. CLINICAL RELEVANCE Inflammatory myofibroblastic tumor in cats have been rarely reported and are usually in the orbital region. In the present report, an unusual multinodular gross presentation, a recurrence over time, and a favorable clinical course, are described.
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120
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Martínez Navarro G, Pérez Chamorro M, Veiga Canuto D, Juan Ribelles A, Fernández Navarro JM. Casuistics of inflammatory myofibroblastic tumor in a tertiary center. An Pediatr (Barc) 2021; 95:364-366. [PMID: 34635462 DOI: 10.1016/j.anpede.2020.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/15/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Gorka Martínez Navarro
- Sección de Oncología y Hematología Infantil, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
| | - María Pérez Chamorro
- Sección de Oncología y Hematología Infantil, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Diana Veiga Canuto
- Servicio de Radiodiagnóstico, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Antonio Juan Ribelles
- Sección de Oncología y Hematología Infantil, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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121
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Shah A, Pey E, Achonu JU, Bai JDK, Khan F. Inflammatory Myofibroblastic Tumor 12 Years After Treatment for Synovial Sarcoma: A Case Report. Orthop Res Rev 2021; 13:163-169. [PMID: 34629909 PMCID: PMC8495227 DOI: 10.2147/orr.s333124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/24/2021] [Indexed: 11/23/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) are mesenchymal neoplasms most seen in the abdominopelvic region, lung, and retroperitoneum; and less commonly seen in virtually any other site. We report a case of two lower limb masses consistent with diagnosis of IMTs. This is a 39-year-old woman with a history of right lower extremity popliteal fossa synovial sarcoma diagnosed 12 years prior and treated with chemotherapy, surgery, and radiation. She presented with two new - one anterior and one posterior - right thigh masses. Biopsies of the lesions demonstrated low-grade inflammatory spindle cell lesions at both sites. Wide resection was performed for both masses and further characterization of the surgical specimens was most consistent with IMT. At follow-up, the patient is well with no signs of recurrence 19 and 7 months postoperative to the resection of the anterior and posterior thigh masses, respectively. This case represents the first reported IMTs occurring as late as 12 years after primary cancer treatment, and the first occurring after synovial sarcoma.
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Affiliation(s)
- Aadit Shah
- Department of Orthopaedics, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Eduard Pey
- Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Justice U Achonu
- Department of Orthopaedics, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Ji Dong K Bai
- Department of Pathology, Stony Brook University Hospital, Stony Brook, NY, USA
| | - Fazel Khan
- Department of Orthopaedics, Stony Brook University Hospital, Stony Brook, NY, USA
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122
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A rare cause of chronic dysphagia: pulmonary inflammatory myofibroblastic tumor with distal esophagus invasion. J Cardiothorac Surg 2021; 16:286. [PMID: 34627314 PMCID: PMC8501738 DOI: 10.1186/s13019-021-01662-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 09/19/2021] [Indexed: 02/08/2023] Open
Abstract
Background Inflammatory myofibroblastic tumor (IMT) is rare intermediate tumor, which happens mostly in children and young adults. Case presentation Reported is the successful treatment of a 29-year-old man presented with progressively dysphagia and weight loss. No other abnormal symptoms were observed. The contrast enhanced computed tomography (CT) revealed a dumbbell-shaped lesion between lung and esophagus. Finally, it was pathologically diagnosed as pulmonary IMT invading to the distal esophagus after operation. The patient underwent partial esophagectomy and left lower lobectomy, and was discharged on 10th postoperative day. Conclusions IMT is a rare lesion that usually occurs in the lung, but pulmonary IMT with distal esophagus invasion has not been described previously. Discriminating untypical symptom, completed resection, pathological expertise and closed follow-up will reach the successful diagnosis and treatment.
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123
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Davis JL, Rudzinski ER. Pediatric and Infantile Fibroblastic/Myofibroblastic Tumors in the Molecular Era. Surg Pathol Clin 2021; 13:739-762. [PMID: 33183731 DOI: 10.1016/j.path.2020.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Pediatric fibroblastic/myofibroblastic tumors are rare but include a wide variety of benign to malignant tumors. Given their uncommon frequency, they may present as a diagnostic dilemma. This article is focused on using clinical and pathologic clues in conjunction with the increasingly relevant and available molecular techniques to classify, predict prognosis, and/or guide treatment in these tumors.
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Affiliation(s)
- Jessica L Davis
- Department of Pathology, Oregon Health & Science University, L-471, Portland, OR 97239, USA.
| | - Erin R Rudzinski
- Department of Laboratories, Seattle Children's Hospital, OC.8.720, Seattle, WA 98105, USA
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124
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Rare presentation of inflammatory myofibroblastic tumor in a failed renal allograft. TRANSPLANTATION REPORTS 2021. [DOI: 10.1016/j.tpr.2021.100078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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125
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Farris N, Sampson M. Single-agent rituximab for treatment of multifocal and multiple relapsed pulmonary inflammatory myofibroblastic tumor in an adolescent patient. Pediatr Blood Cancer 2021; 68:e29131. [PMID: 34101979 DOI: 10.1002/pbc.29131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/28/2021] [Accepted: 05/07/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Nicholas Farris
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio, USA
| | - Megan Sampson
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Akron Children's Hospital, Akron, Ohio, USA
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126
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Dermawan JK, Azzato EM, Goldblum JR, Rubin BP, Billings SD, Ko JS. Superficial ALK-rearranged myxoid spindle cell neoplasm: a cutaneous soft tissue tumor with distinctive morphology and immunophenotypic profile. Mod Pathol 2021; 34:1710-1718. [PMID: 34088997 DOI: 10.1038/s41379-021-00830-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 12/12/2022]
Abstract
Gene rearrangements involving the anaplastic lymphoma kinase (ALK) receptor tyrosine kinase gene have been identified in various neoplasms, including inflammatory myofibroblastic tumor and epithelioid fibrous histiocytoma. We present an ALK-rearranged cutaneous soft tissue tumor with unique morphologic and immunophenotypic features that are not shared by other entities with ALK rearrangements. The six cases involved two females and four males, aged 18-84 (mean 51) years old. Three tumors were on the back and three on the lower extremities (thigh, knee, shin); ranging from 0.5 to 5.6 (mean 2.1) cm. Four were confined to the dermis; two involved the subcutis. All six cases were characterized by the presence of spindled to ovoid cells arranged in concentric whorls and cords against a myxoid to myxohyaline stroma and relatively cellular aggregates of plump ovoid to epithelioid cells. Four cases showed distinct hyalinized blood vessels. Both cases that involved the subcutis showed peripheral lipofibromatosis-like areas. Tumor-infiltrating lymphocytes were absent to moderate. Severe cytologic atypia or conspicuous mitotic activity was not identified. Immunohistochemically, all tumors diffusely expressed ALK (D5F3) and CD34. All but one tumor was diffusely positive for S100 protein. All tumors were negative for EMA, AE1/AE3, SMA, and SOX10. Next-generation sequencing revealed ALK fusions with FLNA (3 cases), MYH10 (2 cases), and HMBOX1 (1 case) as the partner genes. In all six cases, the breakpoints involved exon 20 of ALK, which preserves the receptor tyrosine kinase domains of ALK in the fusion product. Of the four cases with limited follow-up information (2-18 months), none recurred. In conclusion, we report an ALK-rearranged cutaneous soft tissue tumor characterized by the presence of myxoid spindle cell whorls and cords, and co-expression of ALK, CD34, and frequently S100 protein, we term "superficial ALK-rearranged myxoid spindle cell neoplasm".
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Affiliation(s)
- Josephine K Dermawan
- Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Elizabeth M Azzato
- Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - John R Goldblum
- Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Brian P Rubin
- Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Steven D Billings
- Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jennifer S Ko
- Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA.
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127
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Inflammatory myofibroblastic tumor of the spleen: a case report. Radiol Case Rep 2021; 16:3117-3119. [PMID: 34457099 PMCID: PMC8377435 DOI: 10.1016/j.radcr.2021.07.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/07/2021] [Accepted: 07/10/2021] [Indexed: 11/21/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs), otherwise known as the inflammatory pseudotumor, is a rare solid mesenchymal tumor, simulating malignant neoplasms, histologically characterized by the proliferation of spindle cells in a fibrous myxoid stroma containing inflammatory cells. CT and MR imaging are the most used tools in their assessment. Clinical features are nonspecific and depend on the localization of the tumor, radiologic findings are polymorphic and no-conclusive and present a diagnostic challenge to the radiologist. Although histology remains obligatory for the final diagnosis. Heren, we report a case of splenic IMT with histological correlation.
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128
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Oh HH, Joo YE. Rectal inflammatory myofibroblastic tumor: Case report and literature review. Medicine (Baltimore) 2021; 100:e27008. [PMID: 34414993 PMCID: PMC8376367 DOI: 10.1097/md.0000000000027008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/05/2021] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Rectal inflammatory myofibroblastic tumor (IMT) is an extremely rare mesenchymal tumor characterized by a mixture of spindle-shaped myofibroblasts or fibroblasts and inflammatory infiltration of lymphocytes and plasma cells. To date, only 8 cases of rectal IMT have been reported. Herein, we report an additional case of rectal IMT in a 28-year-old woman. PATIENT CONCERNS A 28-year-old woman presented with abdominal pain and hematochezia. DIAGNOSES Colonoscopy showed a 3.0-cm subepithelial tumor with central ulceration, covered by white exudate in the rectum. Rectal magnetic resonance imaging revealed a 4.0 × 3.0-cm-sized well-defined subepithelial tumor in the right wall of the rectum, with suspicious right perirectal fat infiltration. INTERVENTIONS Laparoscopic anterior resection was performed. Microscopic examination of the surgical specimen revealed bland-looking spindle cells intermingled with lymphoplasma cells. Immunohistochemistry and fluorescence in situ hybridization showed anaplastic lymphoma kinase positivity and anaplastic lymphoma kinase positivity rearrangement. Rectal IMT was confirmed based on histological, immunohistochemical, and fluorescence in situ hybridization findings. The patient was doing well without evidence of tumor recurrence 1 year after the surgery. LESSONS Rectal IMT, despite its rarity, should be considered in the differential diagnosis of rectal cancer. Second, an accurate histopathologic diagnosis and complete surgical resection can be the most important approaches to offer a chance for the cure of rectal IMT.
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129
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Schöffski P, Kubickova M, Wozniak A, Blay JY, Strauss SJ, Stacchiotti S, Switaj T, Bücklein V, Leahy MG, Italiano A, Isambert N, Debiec-Rychter M, Sciot R, Lee CJ, Speetjens FM, Nzokirantevye A, Neven A, Kasper B. Long-term efficacy update of crizotinib in patients with advanced, inoperable inflammatory myofibroblastic tumour from EORTC trial 90101 CREATE. Eur J Cancer 2021; 156:12-23. [PMID: 34392187 DOI: 10.1016/j.ejca.2021.07.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/10/2021] [Indexed: 01/26/2023]
Abstract
PURPOSE European Organisation for Research and Treatment of Cancer (EORTC) 90101 (CREATE) was a prospective, multicentric, non-randomised, open-label phase II basket trial to assess the efficacy and safety of crizotinib in patients with different types of cancers, including advanced inflammatory myofibroblastic tumour (IMT) with or without anaplastic lymphoma kinase (ALK) rearrangements. Here, we report updated results with long-term follow-up. PATIENTS/METHODS After central reference pathology, eligible ALK-positive and ALK-negative patients with advanced/metastatic IMT deemed incurable with surgery, radiotherapy or systemic therapy received oral crizotinib 250 mg twice daily. The ALK status was assessed centrally using immunohistochemistry and fluorescence in situ hybridisation. The primary end-point was the proportion of patients who achieved an objective response (i.e. complete or partial response). If ≥6 ALK-positive patients achieved a confirmed response, the trial would be deemed successful. RESULTS At data cut-off on 28th January 2021, we performed the final analysis of this trial. Of the 20 eligible and treated patients (19 of whom were evaluable for efficacy), with a median follow-up of 50 months, five were still on crizotinib treatment (4/12 ALK-positive and 1/8 ALK-negative patients). The updated objective response rate (ORR) was 66.7% (95% confidence interval [CI] 34.9-90.1%) in ALK-positive patients and 14.3% (95% CI 0.0-57.9%) in ALK-negative patients. In the ALK-positive and ALK-negative patients, the median progression-free survival was 18.0 months (95% CI 4.0-NE) and 14.3 months (95% CI 1.2-31.1), respectively; 3-year overall survival rates were 83.3% (95% CI 48.2-95.6) and 34.3% (95% CI 4.8-68.5). Safety results were consistent with previously reported data. CONCLUSION These updated results confirm previous findings that crizotinib is effective, with durable responses, in patients with locally advanced or metastatic ALK-positive IMT. With further follow-up after the original primary analysis, the ORR increased, as patients derived long-term benefit and some responses converted from stable disease to partial responses. CLINICAL TRIAL NUMBER EORTC 90101, NCT01524926.
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Affiliation(s)
- Patrick Schöffski
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Department of Oncology, KU Leuven, Laboratory of Experimental Oncology, Leuven, Belgium; Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium.
| | | | - Agnieszka Wozniak
- Laboratory of Experimental Oncology, Department of Oncology, KU Leuven, Leuven, Belgium
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard/Université Claude Bernard Lyon Institute, Lyon, France
| | - Sandra J Strauss
- Department of Oncology, University College London Hospitals NHS Trust, London, UK
| | - Silvia Stacchiotti
- Department of Medical Oncology, IRCCS Fondazione Istituto Nazionale Tumori, Milano, Italy
| | - Tomasz Switaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Veit Bücklein
- Klinikum der Universität München, Medizinische Klinik III, Campus Grosshadern, Munich, Germany
| | | | | | - Nicolas Isambert
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | | | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Che-Jui Lee
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Department of Oncology, KU Leuven, Laboratory of Experimental Oncology, Leuven, Belgium
| | - Frank M Speetjens
- Department of Medical Oncology, Leiden University Medical Center, Leiden, Netherlands
| | | | - Anouk Neven
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | - Bernd Kasper
- Sarcoma Unit, Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
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130
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Chen ZT, Lin YX, Li MX, Zhang T, Wan DL, Lin SZ. Inflammatory myofibroblastic tumor of the pancreatic neck: A case report and review of literature. World J Clin Cases 2021; 9:6418-6427. [PMID: 34435007 PMCID: PMC8362560 DOI: 10.12998/wjcc.v9.i22.6418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/23/2021] [Accepted: 06/01/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pancreatic inflammatory myofibroblastic tumor (IMT) is a relatively rare disease that is often confused with pancreatic cancer or pancreatic neuroendocrine tumors. The histological features of IMTs show that tissue from this type of tumor contains an intermingling of fibroblast and myofibroblast proliferation, accompanied by a varying degree of inflammatory cell infiltration.
CASE SUMMARY The management of an IMT occurring at the neck of the pancreas is presented in this paper. A 66-year-old female patient was diagnosed with a pancreatic neck mass after a series of tests. The patient underwent enucleation of the pancreatic neck tumor after a pathological diagnosis of IMT. Previous research on the clinical features, pathological diagnosis and treatment of pancreatic IMTs was reviewed. Compared with previous reports, this is a unique case of enucleation of a pancreatic IMT.
CONCLUSION The enucleation of pancreatic IMTs may be a safe and efficient surgical method for managing such tumors with a better prognosis. Further cases are required to explore surgical measures for pancreatic IMTs.
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Affiliation(s)
- Zhi-Tao Chen
- Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou 310000, Zhejiang Province, China
- School of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
| | - Yao-Xiang Lin
- School of Medicine, Hangzhou Normal University, Hangzhou 310003, Zhejiang Province, China
| | - Meng-Xia Li
- School of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Ting Zhang
- Department of Pathology, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou 310000, Zhejiang Province, China
| | - Da-Long Wan
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Sheng-Zhang Lin
- Department of Hepatobiliary Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou 310000, Zhejiang Province, China
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131
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Carcamo B, Bista R, Wilson H, Reddy P, Pacheco J. Rapid Response to Lorlatinib in a Patient With TFG-ROS1 Fusion Positive Inflammatory Myofibroblastic Tumor of the Chest Wall Metastatic to the Brain and Refractory to First and Second Generation ROS1 Inhibitors. J Pediatr Hematol Oncol 2021; 43:e718-e722. [PMID: 34157012 DOI: 10.1097/mph.0000000000002185] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Abstract
Most inflammatory myofibroblastic tumors (IMTs) harbor ALK fusions but oncogene fusions involving ROS1, RET, NTRK, and PDGFR also occur. The recognition that most IMTs harbor receptor tyrosine kinase fusions has provided a rationale for the use of tyrosine kinase inhibitors to target these oncogenic drivers in advanced IMTs. Crizotinib has been effective in ALK and ROS1-positive IMTs but resistance eventually develops. Here we report the successful use of lorlatinib in a patient with heavily pretreated ROS1-positive IMT of the chest wall with acquired crizotinib-resistance and metastasis to the brain.
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Affiliation(s)
- Benjamin Carcamo
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso
- El Paso Children's Hospital, El Paso, TX
| | - Ranjan Bista
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso
- El Paso Children's Hospital, El Paso, TX
| | - Harry Wilson
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso
| | | | - Jose Pacheco
- University of Colorado Cancer Center, Anschutz Medical Campus, Aurora CO
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132
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Mahajan P, Casanova M, Ferrari A, Fordham A, Trahair T, Venkatramani R. Inflammatory myofibroblastic tumor: molecular landscape, targeted therapeutics, and remaining challenges. Curr Probl Cancer 2021; 45:100768. [PMID: 34244015 DOI: 10.1016/j.currproblcancer.2021.100768] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/21/2021] [Indexed: 12/29/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor of intermediate malignant potential that predominantly affects children, adolescents and young adults. IMT has a predilection for the lung, abdomen, pelvis, and retroperitoneum, however, can affect any part of the body. IMT is typically localized, and multifocal or metastatic disease is uncommon. Complete surgical resection is the treatment of choice when feasible. There is no established standard of care for unresectable and advanced IMT. Approximately half of IMTs harbor anaplastic lymphoma kinase (ALK) gene rearrangements, and fusions involving ROS1, PDGFRβ, RET and NTRK have also been described. Given the molecular landscape of IMT, management of these tumors has evolved to include tyrosine kinase inhibitors and novel targeted therapeutics. This review highlights the molecular characteristics, evolution of targeted therapies and the remaining challenges in the management of IMT.
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Affiliation(s)
- Priya Mahajan
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, Texas
| | - Michela Casanova
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Ashleigh Fordham
- Children's Cancer Institute, C25 Lowy Cancer Research Centre, UNSW Sydney New South Wales, Australia
| | - Toby Trahair
- Children's Cancer Institute, C25 Lowy Cancer Research Centre, UNSW Sydney New South Wales, Australia; Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia; School of Women's and Children's Health, UNSW Medicine, New South Wales, Australia
| | - Rajkumar Venkatramani
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, Texas.
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133
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Therapeutic options in inoperable ROS1-rearranged inflammatory myofibroblastic tumor of the tongue in a child: a case report and literature review. Anticancer Drugs 2021; 32:1111-1115. [PMID: 34145176 DOI: 10.1097/cad.0000000000001099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare borderline malignancy, usually treated with surgery only. Exceedingly rare cases of inoperable, recurrent, or metastatic IMTs pose a therapeutic challenge. We report successful treatment of a 7-year-old girl with an inoperable anaplastic lymphoma kinase (ALK)-negative IMT of the tongue. The patient underwent various anti-inflammatory (steroids, nonsteroidal anti-inflammatory drugs, clarithromycin) and antiproliferative (chemotherapy) therapies to enable tumor regression and complete resection. Ultimately, next-generation sequencing of the tumor revealed a TFG-ROS-1 translocation, allowing for an off-label targeted therapy with crizotinib. Crizotinib treatment caused slight tumor regression but evident change of its structure, allowing for complete non-mutilating resection. Two histopathology examinations revealed complete disappearance of neoplastic cells following therapy. The patient remains disease-free 22 months after the delayed surgery. In children with inoperable ALK-negative IMTs, molecular testing must be performed to identify other targetable oncogenic fusions, including TFG-ROS1.
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134
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Suzuki S, Ohtani M, Matsuo Y, Yoshida M, Goto A, Fukuda M, Mimasaka S. A forensic autopsy case: Sudden unexpected death due to cardiac inflammatory myofibroblastic tumor. Leg Med (Tokyo) 2021; 53:101931. [PMID: 34147823 DOI: 10.1016/j.legalmed.2021.101931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/16/2021] [Accepted: 05/09/2021] [Indexed: 11/19/2022]
Abstract
We report an autopsy case of a 25-year-old man with no medical history who died suddenly in an Internet cafe. He was found in cardiorespiratory arrest and did not respond to cardiopulmonary resuscitation. Traumatic lesions were not observed on his body. An autopsy was performed to investigate the cause of death. Upon examination, we discovered a heart tumor that infiltrated from the outside wall to the outflow tract of the left ventricle. Left ventricular outflow tract obstruction due to a cardiac tumor was considered the mechanism of death. Histological examination identified an inflammatory myofibroblastic tumor (IMT). The final diagnosis was death secondary to circulatory failure due to a cardiac IMT. Additionally, a cardiac tumor was diagnosed using post-mortem computed tomography. Only few cases of sudden unexpected death due to cardiac IMT have been reported; we report this case along with a review of the literature.
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Affiliation(s)
- Shoken Suzuki
- Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita, Japan; Department of Dentistry and Oral Surgery, Akita University Graduate School of Medicine, Akita, Japan.
| | - Maki Ohtani
- Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita, Japan.
| | - Yuhei Matsuo
- Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita, Japan.
| | - Makoto Yoshida
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan.
| | - Akiteru Goto
- Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan.
| | - Masayuki Fukuda
- Department of Dentistry and Oral Surgery, Akita University Graduate School of Medicine, Akita, Japan.
| | - Sohtaro Mimasaka
- Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita, Japan.
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135
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Sbaraglia M, Businello G, Bellan E, Fassan M, Dei Tos AP. Mesenchymal tumours of the gastrointestinal tract. Pathologica 2021; 113:230-251. [PMID: 34294940 PMCID: PMC8299319 DOI: 10.32074/1591-951x-309] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Mesenchymal tumours represent a heterogenous group of neoplasms encopassing benign, intermediate malignancy, and malignant entities. Sarcomas account for approximately 1% of human malignancies. In consideration of their rarity as well as of intrinsic complexity, diagnostic accuracy represents a major challenge. Traditionally, mesenchymal tumours are regarded as lesions the occurrence of which is mostly limited to somatic soft tissues. However, the occurrence of soft tissue tumours at visceral sites represent a well recognized event, and the GI-tract ranks among the most frequently involved visceral location. There exist entities such as gastrointestinal stromal tumours (GIST) and malignant gastointestinal neuroectodermal tumors that exhibit exquisite tropism for the GI-tract. This review will focus also on other relevant clinico-pathologic entities in which occurrence at visceral location is not at all negligible.
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Affiliation(s)
- Marta Sbaraglia
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, Italy.,Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Gianluca Businello
- Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Elena Bellan
- Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Matteo Fassan
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, Italy.,Department of Medicine, University of Padua School of Medicine, Padua, Italy
| | - Angelo Paolo Dei Tos
- Department of Pathology, Azienda Ospedale-Università Padova, Padua, Italy.,Department of Medicine, University of Padua School of Medicine, Padua, Italy
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136
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Jang EJ, Kim KW, Kang SH, Pak MG, Han SH. Inflammatory myofibroblastic tumors arising from pancreas head and peri-splenic area mimicking a malignancy. Ann Hepatobiliary Pancreat Surg 2021; 25:287-292. [PMID: 34053934 PMCID: PMC8180395 DOI: 10.14701/ahbps.2021.25.2.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/04/2021] [Accepted: 03/04/2021] [Indexed: 11/17/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) are a rare chronic inflammatory disease with unclear pathogenesis and pathological features that are not those of a malignant tumor. It is difficult to differentially diagnose them without surgical excision because of their unpredictable clinical behavior, which ranges from benign to locally invasive aggressiveness. We report two cases of IMTs that were diagnosed after surgery. In one case, the IMT originated in peri-splenic area in a 63-year-old female patient. The other case involved a 48-year-old female patient who suffered from an IMT of the head of the pancreas. Both of these cases did not require further treatment based on histological findings, and there has been no evidence of recurrence or metastasis so far. These cases show that the primary choice for the exact diagnosis and proper treatment of IMTs is complete surgical resection.
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Affiliation(s)
- Eun Jeong Jang
- Department of Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
| | - Kwan Woo Kim
- Department of Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
| | - Sung Hwa Kang
- Department of Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
| | - Min Gyoung Pak
- Department of Pathology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
| | - Song Hee Han
- Department of Pathology, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea
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137
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Ingley KM, Hughes D, Hubank M, Lindsay D, Plumb A, Cox R, Chesler L, Strauss SJ. Durable response to serial tyrosine kinase inhibitors (TKIs) in an adolescent with metastatic TFG-ROS1 fusion positive Inflammatory Myofibroblastic Tumor (IMT). Lung Cancer 2021; 158:151-155. [PMID: 34059352 DOI: 10.1016/j.lungcan.2021.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/15/2021] [Accepted: 05/22/2021] [Indexed: 10/21/2022]
Abstract
Here, we present the case of an adolescent with a rare metastatic Inflammatory myofibroblastic tumor (IMT) harboring a TFG-ROS1 fusion initially detected on tumor progression and retrospectively identified in the primary tumor after targeted RNA sequencing. The patient benefitted from sequential TKIs over a 5-year period with response to the third generation ALK/ROS inhibitor, lorlatinib leading to resection of the primary tumor. Detailed molecular analysis can identify targetable oncogenic kinase fusions that alters management in patients with unresectable disease and should be considered in all patients.
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Affiliation(s)
- Katrina M Ingley
- London Sarcoma Service, University College London Hospitals NHS Trust, United Kingdom
| | - Debbie Hughes
- Clinical Genomics Translational Research, Centre for Molecular Pathology, The Institute of Cancer Research Sutton, United Kingdom
| | - Michael Hubank
- Molecular Diagnostics Department, The Institute of Cancer Research and Clinical Genomics, The Royal Marsden NHS Foundation, London, United Kingdom
| | - Daniel Lindsay
- Department of Histopathology, Royal National Orthopaedic Hospital NHS Trust, Stanmore, United Kingdom
| | - Andrew Plumb
- Department of Radiology, University College London Hospitals NHS Trust, United Kingdom
| | - Rachel Cox
- Department of Paediatric Oncology, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, BS2 8BJ, United Kingdom
| | - Louis Chesler
- Paediatric Tumor Biology, Division of Clinical Studies, The Institute of Cancer Research, London, United Kingdom
| | - Sandra J Strauss
- London Sarcoma Service, University College London Hospitals NHS Trust, United Kingdom; UCL Cancer Institute, London, United Kingdom.
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138
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Debonis SA, Bongiovanni A, Pieri F, Fausti V, De Vita A, Riva N, Gurrieri L, Vanni S, Diano D, Mercatali L, Ibrahim T. ALK-negative lung inflammatory myofibroblastic tumor in a young adult: A case report and literature review of molecular alterations. Medicine (Baltimore) 2021; 100:e25972. [PMID: 34011083 PMCID: PMC8137108 DOI: 10.1097/md.0000000000025972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 04/28/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor that is prevalent among children and adolescents. Surgery is the most important therapeutic approach for IMT and complete resection is recommended. Although 50% of IMTs show anaplastic lymphoma kinase (ALK) rearrangements, crizotinib has proven an effective therapeutic approach. However, the genetic landscape of this tumor is still not fully understood and treatment options are limited, especially in the majority of ALK-negative tumors. PATIENT CONCERNS We describe the clinical case of a healthy 18-year-old female in whom a pulmonary nodule was incidentally detected. DIAGNOSES Following a small increase in the size of the nodule, the patient underwent both 18FDG-PET/CT and 68Ga-PET/CT, resulting in a suspicion of bronchial hamartoma. INTERVENTIONS The patient underwent surgery and a salivary gland-like lung tumor was diagnosed. OUTCOMES After surgery, the patient was referred to our cancer center, where a review of the histology slides gave a final diagnosis of ALK-negative lung IMT. Given the histology, it was decided not to administer adjuvant therapy and the patient was placed in a 3-monthly follow-up program. The patient is still disease-free 2 years post-surgery. LESSONS Although there is no standard of care for the treatment of IMT, identifying genomic alterations could help to redefine the management of patients with negative-ALK disease. Our review of the literature on IMT and other kinase fusions revealed, in addition to ALK rearrangements, the potential association of ROS1, NTRK, RET, or PDGFR beta alterations with the tumor.
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Affiliation(s)
- Silvia Angela Debonis
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola
| | | | - Valentina Fausti
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola
| | - Alessandro De Vita
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola
| | - Nada Riva
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola
| | - Lorena Gurrieri
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola
| | - Silvia Vanni
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola
| | - Danila Diano
- Radiology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola, Italy
| | - Laura Mercatali
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori,” Meldola
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139
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Liu Z, Li G, Gou A, Xiao Z, Xu Y, Song S, Guo K, Ma G. Inflammatory myofibroblastic tumor in the pancreatic neck: a rare case report and literature review. Gland Surg 2021; 10:1832-1839. [PMID: 34164329 DOI: 10.21037/gs-21-303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare disease of unknown etiology. It usually occurs in abdominal soft tissues and lung, and is extremely rare in the pancreas. IMT can occur in any part of a person at any age, however, it mostly affects children and young people. Its clinical manifestations are atypical, imaging examinations are not specific, and the differential diagnosis of pancreatic malignancies is difficult, making it easily misdiagnosed. Surgical resection is the preferred method of treatment for IMT. In this case report, we report a rare case of IMT in the neck of the pancreas and reviewed the relevant literature. In our case, the patient was a 57-year-old woman with an IMT in the neck of the pancreas. Abdominal pain was the only clinical symptom, and imaging features were not specific. She underwent surgery to remove the pancreatic mass, and the final diagnosis of IMT was based on histopathology and immunohistochemistry. After 6 months of regular follow-up, the patient had no complications or further incidents. The purpose is to emphasize the difficulty of the preoperative diagnosis of pancreatic IMT and the difficulty of distinguishing it from pancreatic malignancies. It is hoped that clinicians can gain a deeper understanding of pancreatic IMT through this case report.
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Affiliation(s)
- Zhe Liu
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang, China
| | - Guichen Li
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang, China
| | - Anjiang Gou
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang, China
| | - Zhihuan Xiao
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang, China
| | - Yuanhong Xu
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang, China
| | - Shaowei Song
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang, China
| | - Kejian Guo
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang, China
| | - Gang Ma
- Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang, China
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140
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Vijayakumar N, Thattaliyath B, Dundar B, Karimi M, Badheka A, Chegondi M. A Rare Inflammatory Myofibroblastic Tumor of the Mitral Valve With Systemic Embolism in a Child. World J Pediatr Congenit Heart Surg 2021; 12:783-784. [PMID: 33896257 DOI: 10.1177/2150135120956629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Inflammatory myofibroblastic tumors (IMTs) represent mesenchymal tumors that occur in the lungs, abdomen, or pelvis. Cardiac IMTs are rare, usually right-sided, and when left-sided can cause sudden cardiac death by coronary occlusion. We report a child with symptoms of embolization to the right kidney and the femoral artery, and a mobile mass in the left atrium attached to the mitral valve. Upon surgical removal, histopathology revealed IMT. Our case illustrates a unique presentation of systemic thromboembolism.
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Affiliation(s)
- Niranjan Vijayakumar
- Division of Pediatric Critical Care, Department of Pediatrics, Stead Family Children's Hospital, University of Iowa, Iowa City, IA, USA
| | - Bijoy Thattaliyath
- Division of Pediatric Cardiology, Department of Pediatrics, Stead Family Children's Hospital, University of Iowa, Iowa City, IA, USA
| | - Bilge Dundar
- Department of Pathology, University of Iowa, Iowa City, IA, USA
| | - Mohsen Karimi
- Pediatric Cardiothoracic Surgery, Stead Family Children's Hospital, University of Iowa, Iowa City, IA, USA
| | - Aditya Badheka
- Division of Pediatric Critical Care, Department of Pediatrics, Stead Family Children's Hospital, University of Iowa, Iowa City, IA, USA
| | - Madhuradhar Chegondi
- Division of Pediatric Critical Care, Department of Pediatrics, Stead Family Children's Hospital, University of Iowa, Iowa City, IA, USA
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141
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West CE, Workman A, Moody T, Hosler GA. Rare presentation of inflammatory myofibroblastic tumor on a digit. J Cutan Pathol 2021; 48:965-968. [PMID: 33754372 DOI: 10.1111/cup.14016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/10/2021] [Accepted: 03/18/2021] [Indexed: 11/27/2022]
Abstract
Inflammatory myofibroblastic tumors (IMTs) are rare soft tissue neoplasms consisting of a mixture of spindle-shaped myofibroblasts or fibroblasts and a variable inflammatory infiltrate composed of eosinophils, plasma cells, and lymphocytes. Associations with trauma and infectious agents have been proposed, but the etiology is unknown. While IMT predominantly develops in the lungs of pediatric patients or young adults, extrapulmonary IMT is well documented and may occur anywhere. Cutaneous IMT is rare and few have been reported on the hand in the English language. The mean age of onset is 10 years, with a slight female predilection. IMT demonstrates intermediate malignant potential, with a tendency to recur locally. Metastases are rare. According to a recent review, anaplastic lymphoma kinase (ALK) positivity on immunohistochemistry is related to local recurrence, but not distant metastases. We report an unusual case of a 36-year-old male, with a lesion on the right second digit, displaying classic histopathologic and immunohistochemical features of IMT, including ALK staining, and confirmatory fluorescence in situ hybridization-proven ALK gene rearrangement.
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Affiliation(s)
| | - Ashleigh Workman
- Department of Dermatology, University of North Texas Health Science Center, Ft. Worth, Texas, USA
| | - Tricia Moody
- CarePath Diagnostic Partners, Tampa, Florida, USA
| | - Gregory A Hosler
- ProPath, Dallas, Texas, USA.,Dermatology and Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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142
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Lenh BV, Duc NM, My TTT, Van ND, Huong BTM, Trung HV, Bang MTL, Thong PM. A rare case of inflammatory myofibroblastic tumor of the vulva in a newborn. Radiol Case Rep 2021; 16:1352-1354. [PMID: 33897928 PMCID: PMC8055520 DOI: 10.1016/j.radcr.2021.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/11/2021] [Accepted: 03/12/2021] [Indexed: 12/04/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is an uncommon neoplasm that rarely arises in the genitourinary system. IMTs in the vulva in infants are extremely rare in the literature. The tumor consists of myofibroblastic spindle cells accompanied by inflammatory cell infiltration. In this article, we aimed to describe the case of IMT in the vulva. A newborn girl presented with a mass in the vulva detected in the prenatal period. The patient was treated with surgery and chemotherapy. Follow-up 8 months after surgery showed no signs of recurrence. In conclusion, IMT has a variable clinical presentation, surgery is the optimal approach, but in cases without complete resection, chemotherapy is essential.
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Affiliation(s)
- Bui-Van Lenh
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam
| | - Nguyen Minh Duc
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam.,Department of Radiology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.,Department of Radiology, Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Thieu-Thi Tra My
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam
| | - Nguyen Dinh Van
- Department of Oncology and Hematology, Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Bui-Thi My Huong
- Department of Oncology and Hematology, Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Hoang-Van Trung
- Department of Radiology, Thien Hanh Hospital, Buon Ma Thuot City, Vietnam
| | - Mai Tan Lien Bang
- Department of Radiology, Children's Hospital 2, Ho Chi Minh City, Vietnam
| | - Pham Minh Thong
- Department of Radiology, Ha Noi Medical University, Ha Noi, Vietnam
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143
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Iyer A, Radonic T, Heukamp LC, Thunnissen E, Daniels JMA. Inflammatory myofibroblastic tumour of the central airways: treatment and molecular analysis. ERJ Open Res 2021; 7:00151-2020. [PMID: 33778057 PMCID: PMC7983254 DOI: 10.1183/23120541.00151-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 11/13/2020] [Indexed: 11/17/2022] Open
Abstract
Inflammatory myofibroblastic tumours (IMT) are a rare cause of endobronchial masses in adults. Surgery has been the mainstay of treatment of endobronchial IMTs, based on the potential for recurrence. Interventional pulmonology has emerged as a minimally invasive and lung function preserving modality in management of airway obstruction due to tumours. We present a series of three adult patients with IMT treated endobronchially with a short discussion on its potential role. We also discuss how molecular analysis of IMTs for mutations in genes such as ALK and ROS1 might provide insights into clinical behaviour and potential targetable therapy in advanced, unresectable and metastatic cases. Inflammatory myofibroblastic tumours in central airways: bronchoscopic treatment of a “not so pseudo-” tumourhttps://bit.ly/2KgPntq
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Affiliation(s)
- Aparna Iyer
- Dept of Pulmonary Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Teodora Radonic
- Dept of Pathology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Lukas C Heukamp
- Institute of Haematopathology Hamburg, Hamburg, Germany.,Lung Cancer Network NOWEL.org, Oldenburg, Germany
| | - Erik Thunnissen
- Dept of Pathology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Johannes M A Daniels
- Dept of Pulmonary Medicine, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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144
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Jacobs C, Lapeire L. Translating Molecular Profiling of Soft Tissue Sarcomas into Daily Clinical Practice. Diagnostics (Basel) 2021; 11:diagnostics11030512. [PMID: 33799327 PMCID: PMC7999686 DOI: 10.3390/diagnostics11030512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 12/22/2022] Open
Abstract
Soft tissue sarcomas are a group of rare mesenchymal tumors with more than 70 subtypes described. Treatment of these subtypes in an advanced setting is mainly according to a one-size-fits-all strategy indicating a high unmet need of new and more targeted therapeutic options in order to optimize survival. The introduction of advanced molecular techniques in cancer has led to better diagnostics and identification of new therapeutic targets, leading to more personalized treatment and improved prognosis for several cancer types. In sarcoma, a likewise evolution is seen, albeit at a slower pace. This manuscript describes how in the past years advanced molecular profiling in soft tissue sarcomas was able to identify specific and often pathognomonic aberrations, deferring standard sarcoma treatment in favor of more targeted treatment from an oncologist’s point of view.
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Affiliation(s)
- Celine Jacobs
- Department of Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Lore Lapeire
- Department of Medical Oncology, Ghent University Hospital, 9000 Ghent, Belgium;
- Cancer Research Institute Ghent (CRIG), Ghent University, 9000 Ghent, Belgium
- Correspondence:
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145
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Wang Y, Zhuang Y, Pan Y. Colonic Inflammatory Myofibroblastic Tumor. J Gastrointest Surg 2021; 25:854-855. [PMID: 32632730 DOI: 10.1007/s11605-020-04711-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 01/31/2023]
Affiliation(s)
- Yurong Wang
- Division of General Surgery, Peking University First Hospital, Peking University, 8 Xi ShiKu Street, Beijing, 100034, People's Republic of China
| | - Yan Zhuang
- Division of General Surgery, Peking University First Hospital, Peking University, 8 Xi ShiKu Street, Beijing, 100034, People's Republic of China
| | - Yisheng Pan
- Division of General Surgery, Peking University First Hospital, Peking University, 8 Xi ShiKu Street, Beijing, 100034, People's Republic of China.
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146
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Ka K, Foba ML, Ka S, Dieng MM, Gaye PM, Dem A. [Extramammary myofibroblastoma affecting the pelvic region: a case report]. Pan Afr Med J 2021; 38:154. [PMID: 33995761 PMCID: PMC8077639 DOI: 10.11604/pamj.2021.38.154.28060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 11/11/2022] Open
Abstract
Un myofibroblastome de type mammaire est une tumeur molle rare; les myofibroblastomes extramammaires sont particulièrement rare. Un homme de 78 ans s'est présenté en consultation pour des douleurs pelviennes soulagées par la défécation ou les urines. Le toucher rectal retrouve une masse en avant de la paroi rectale antérieure. L'imagerie par résonance magnétique (IRM) montre une masse de 10 x 6 x 8cm, bien circonscrite et hétérogène, située en arrière de la vessie qu'elle refoule vers l'avant, en avant du recto-sigmoïde. L'immunohistochimie montre des cellules tumorales co-exprimant CD34 et la desmine de façon diffuse, expression de Rb dans la majorité des cellules, expression des récepteurs aux œstrogènes, expression intense et diffuse de la P16, un index de prolifération avec le ki67 estimé à 25%. Il n'y a pas eu de récidive après 8 mois de radiothérapie d'induction suivie de chirurgie. Un myofibroblastome de type mammaire est une tumeur rare et bénigne. La récidive n'est quasiment pas observée après traitement local. Ce cas permet de mettre en avance la possibilité d'utiliser la radiothérapie afin de faciliter la chirurgie.
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Affiliation(s)
- Kanta Ka
- Service de Radiothérapie, Centre Hospitalier National Universitaire Dalal Jamm, Guédiawaye, Sénégal
| | - Mamadou Lassana Foba
- Université Cheikh Anta Diop de Dakar, Dakar, Sénégal.,Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Sidy Ka
- Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal.,Service d'Oncologie, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Mamadou Moustapha Dieng
- Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal.,Service d'Oncologie, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Papa Macoumba Gaye
- Service de Radiothérapie, Centre Hospitalier National Universitaire Dalal Jamm, Guédiawaye, Sénégal.,Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Ahmadou Dem
- Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal.,Service d'Oncologie, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
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147
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Walsh EM, Xing D, Lippitt MH, Fader AN, Wethington SL, Meyer CF, Gaillard SL. Molecular Tumor Board Guides Successful Treatment of a Rare, Locally Aggressive, Uterine Mesenchymal Neoplasm. JCO Precis Oncol 2021; 5:PO.20.00189. [PMID: 34250413 DOI: 10.1200/po.20.00189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 12/23/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
- Elaine M Walsh
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD.,Breast Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Deyin Xing
- Department of Pathology, Johns Hopkins Hospital, Baltimore, MD
| | - Melissa H Lippitt
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Johns Hopkins Hospital, Baltimore, MD.,NorthShore University HealthSystem, Evanston, IL
| | - Amanda N Fader
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Johns Hopkins Hospital, Baltimore, MD
| | - Stephanie L Wethington
- Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Johns Hopkins Hospital, Baltimore, MD
| | - Christian F Meyer
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD
| | - Stephanie L Gaillard
- Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital, Baltimore, MD.,Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Johns Hopkins Hospital, Baltimore, MD
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148
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Pseudosarcomatous myofibroblastic proliferations of the urinary bladder are neoplasms characterized by recurrent FN1-ALK fusions. Mod Pathol 2021; 34:469-477. [PMID: 32908253 DOI: 10.1038/s41379-020-00670-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 11/08/2022]
Abstract
Pseudosarcomatous myofibroblastic proliferation is a descriptive term that designates a group of clinically indolent genitourinary lesions that most commonly arise in the urinary bladder. Given that pseudosarcomatous myofibroblastic proliferation may show morphologic overlap with inflammatory myofibroblastic tumor, the relationship, if any, between the two entities has been unclear. Moreover, pseudosarcomatous myofibroblastic proliferations are known to be positive for ALK immunohistochemistry in a subset of cases, although an inconsistent association with ALK rearrangement (ranging from 0 to 60%) has been reported. The objectives of this study were to determine the frequency of ALK rearrangement and to identify fusion partners using fluorescence in situ hybridization (FISH) and targeted RNA sequencing studies in a contemporary series of 30 pseudosarcomatous myofibroblastic proliferations of the urinary bladder, as well as to investigate ROS1 status by immunohistochemistry. ALK immunohistochemistry was positive in 70% (21/30) of pseudosarcomatous myofibroblastic proliferations; ROS1 immunohistochemistry was consistently negative (0/28). ALK rearrangements were detected by FISH in 86% (18/21) of cases, correlating with ALK immunohistochemical positivity in all but 3 cases. Of eight cases confirmed to be ALK rearranged by FISH, targeted RNA-sequencing detected FN1-ALK fusions in seven (88%) cases, which involved exons 20-26 of FN1 (5') and exon 18-19 of ALK (3'). In conclusion, ALK rearrangements are frequent in pseudosarcomatous myofibroblastic proliferations, typically involving exon 19, and FN1 appears to be a consistent fusion partner. Given the significant clinicopathologic differences between inflammatory myofibroblastic tumor and pseudosarcomatous myofibroblastic proliferation, our findings provide further support for classification of pseudosarcomatous myofibroblastic proliferation as a distinct clinicopathologic entity, and propose the alternate terminology "pseudosarcomatous myofibroblastic neoplasm of the genitourinary tract."
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149
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Hajong R, Newme K, Khongwar D. Primary inflammatory myofibroblastic tumor of stomach-report of a very rare case. J Family Med Prim Care 2021; 10:552-553. [PMID: 34017787 PMCID: PMC8132761 DOI: 10.4103/jfmpc.jfmpc_1126_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/09/2020] [Accepted: 12/01/2020] [Indexed: 11/22/2022] Open
Abstract
Primary inflammatory myofibroblastic tumor (IMT) is a very rare tumor arising from stomach and it closely mimics gastric GIST. It usually affects the lung and found in children and young patients. The diagnosis of gastric IMT is usually done post-operatively by immunohistochemistry examination where it is seen that IMT is positive to SMA and vimentin. Complete surgical excision is the treatment of choice and local recurrence is usually seen in incompletely resected cases.
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Affiliation(s)
- Ranendra Hajong
- Department of General Surgery, NEIGRIHMS, Shillong, Meghalaya, India
| | | | - Donkupar Khongwar
- Department of General Surgery, NEIGRIHMS, Shillong, Meghalaya, India
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150
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Martínez Navarro G, Pérez Chamorro M, Veiga Canuto D, Juan Ribelles A, Fernández Navarro JM. [Casuistics of inflammatory myofibroblastic tumor in a tertiary center]. An Pediatr (Barc) 2021; 95:S1695-4033(20)30526-9. [PMID: 33495091 DOI: 10.1016/j.anpedi.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/24/2020] [Accepted: 12/15/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Gorka Martínez Navarro
- Sección de Oncología y Hematología Infantil. Hospital Universitari i Politècnic La Fe, Valencia, España.
| | - María Pérez Chamorro
- Sección de Oncología y Hematología Infantil. Hospital Universitari i Politècnic La Fe, Valencia, España
| | - Diana Veiga Canuto
- Servicio de Radiodiagnóstico. Hospital Universitari i Politècnic La Fe, Valencia, España
| | - Antonio Juan Ribelles
- Sección de Oncología y Hematología Infantil. Hospital Universitari i Politècnic La Fe, Valencia, España
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