1
|
Huang K, Zhao P, Zhao J, Zhao P, Yang J. A unique case of inflammatory myofibroblastic tumor of the liver manifesting with biloma: A case report. Oncol Lett 2022; 24:227. [PMID: 35720485 PMCID: PMC9185161 DOI: 10.3892/ol.2022.13348] [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: 12/24/2021] [Accepted: 04/22/2022] [Indexed: 02/05/2023] Open
Abstract
Anaplastic lymphoma kinase (ALK)-negative hepatic inflammatory myofibroblastic tumors (IMTs) harboring the ETS variant transcription factor 6-neurotrophic receptor tyrosine kinase 3 (ETV6-NTRK3) fusion gene and manifesting with biloma are extremely rare, and their biological behavior is unclear. The present study reports the case of a 45-year-old female with ALK-negative IMT of the liver harboring the ETV6-NTRK3 fusion gene and manifesting with biloma. Computed tomography of the abdomen confirmed the lesions to be a low-density mass, measuring 11.2×8.5×10.5 cm, located in the left lobe of the liver, and a lower-density mass, measuring 8.5×6.1×5.9 cm, located in the interior of the tumor. As the suspicion of a malignancy remained high, surgical resection of the left hepatic lobe, including the tumor, was undertaken. Intraoperatively, a tumor (12×10×9 cm), with an unclear boundary, incomplete capsule and fish-like texture, was found in the left lateral lobe of the liver, and a biloma, measuring 8×6 cm, was identified inside the tumor. Pathological examination revealed spindle cell proliferation with infiltration of chronic inflammatory cells and mucinous degeneration. Immunohistochemical studies showed negativity for ALK, CD117, CD34, discovered on GIST-1, desmin, smooth muscle actin, S-100, CD21, pan-cytokeratin, epithelial membrane antigen, CD23 and CD35, but positivity for vimentin staining, and 5% Ki-67-positive cells. Fluorescence in situ hybridization studies assessing characteristic genetic rearrangements using ALK, RET, ROS1, MDM2, MGEA5 and ETV6 break-apart assays, revealed the presence of the ETV6-NTRK3 fusion oncogene and negativity for ALK, RET, ROS1, MDM2 and MGEA5. The patient was discharged 7 days post-operatively, without any adjuvant treatment. No recurrence of symptoms was noted at the 3-year follow-up. To the best of our knowledge, this is the first report of biloma in an ALK-negative IMT of the liver, which may increase our understanding of hepatic IMT.
Collapse
Affiliation(s)
- Kun Huang
- Department of General Surgery, Mianyang Hospital of Traditional Chinese Medicine, Mianyang, Sichuan 621000, P.R. China
| | - Pingwu Zhao
- Department of General Surgery, Mianyang Hospital of Traditional Chinese Medicine, Mianyang, Sichuan 621000, P.R. China
| | - Jiangying Zhao
- Department of Pathology, Mianyang Hospital of Traditional Chinese Medicine, Mianyang, Sichuan 621000, P.R. China
| | - Pan Zhao
- Department of General Surgery, Mianyang Hospital of Traditional Chinese Medicine, Mianyang, Sichuan 621000, P.R. China
| | - Jian Yang
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610000, P.R. China
| |
Collapse
|
2
|
Ho KC, Shen YH, Wu PS, Lee WC, Liu TP, Ko WC, Yang PS, Liu CL. Dedifferentiated liposarcoma masquerading as a recurrent inflammatory pseudotumor. JOURNAL OF CANCER RESEARCH AND PRACTICE 2022. [DOI: 10.4103/jcrp.jcrp_12_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
3
|
Retroperitoneal Sarcomas: An Update on the Diagnostic Pathology Approach. Diagnostics (Basel) 2020; 10:diagnostics10090642. [PMID: 32867125 PMCID: PMC7555595 DOI: 10.3390/diagnostics10090642] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 02/07/2023] Open
Abstract
Retroperitoneal sarcomas are a heterogenous group of rare tumors arising in the retroperitoneum. Retroperitoneal sarcomas comprise approximately 10% of all soft tissue sarcomas. Though any soft tissue sarcoma histologic types may arise in the retroperitoneal space, liposarcoma (especially well-differentiated and dedifferentiated types) and leiomyosarcoma do so most commonly. Retroperitoneal sarcomas are diagnostically challenging, owing to their diversity and morphological overlap with other tumors arising in the retroperitoneum. An accurate diagnosis is necessary for correct management and prognostication. Herein, we provide an update on the diagnostic approach to retroperitoneal sarcomas and review their key histologic findings and differential diagnoses.
Collapse
|
4
|
Doroudinia A, Kaghazchi F, Mehrian P, Dorudinia A. Recurrent inflammatory myofibroblastic tumour of the lung: FDG PET/CT scan findings. BMJ Case Rep 2018; 2018:bcr-2018-224373. [PMID: 30007906 DOI: 10.1136/bcr-2018-224373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inflammatory myofibroblastic tumour (IMT) is a rare neoplasm, occurring most often in children and young adults. IMTs have intermediate biological behaviour with the chance of local invasion, recurrence and even distant metastasis. Wide range of clinical presentations makes the precise diagnosis of IMT more challenging. The best method for definitive diagnosis is tissue biopsy and newer imaging modalities including fleurodeoxyglucose (FDG) positron emission tomography (PET)/CT are useful tools in detection of disease recurrence or distant metastasis. Complete surgical resection is the best-known treatment for this tumour. Here we are presenting an IMT case in a 12-year-old girl in which her recurrent pulmonary IMT was diagnosed based on FDG PET/CT findings and referred for further salvage treatment. Overall imaging modalities are not specific, but PET/CT scan can be useful tool for evaluation of IMT regarding initial staging and restaging to assess treatment response and recurrence.
Collapse
Affiliation(s)
- Abtin Doroudinia
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Kaghazchi
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Payam Mehrian
- Department of Radiology, Telemedicine Research Center (TRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atosa Dorudinia
- Department of Pathology, Tracheal Diseases Research Center (TDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Masih Daneshvari Hospital. Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Shahidi-Dadras M, Abdollahimajd F, Barzkar N, Kani ZA, Nikvar M. Paraneoplastic Pemphigus with Underlying Retroperitoneal Inflammatory Myofibroblastic Tumor: A Case Report and Review of the Literature. Indian Dermatol Online J 2017; 8:478-481. [PMID: 29204394 PMCID: PMC5707843 DOI: 10.4103/idoj.idoj_17_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a peculiar low-grade neoplasm of spindle cell fibroblasts and myofibroblasts in an inflammatory background. The lung is the most common site of involvement. Here, we report a case of paraneoplastic pemphigus (PNP)-associated with an extensive retroperitoneal IMT. The patient had a favourable response following treatment with a low dose of systemic steroid, mycophenolate mofetil, and intravenous immunoglobulin (IVIG). He subsequently underwent surgery for resection of the tumor with nephrectomy and five courses of IVIG were administered after surgery due to a minor relapse. He was in remission in her last follow-up visit 16 months after surgery. The occurrence of PNP with IMT is notable; early detection and treatment are crucial for this tumor-associated autoimmune disease.
Collapse
Affiliation(s)
| | | | - Nasibeh Barzkar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Asadi Kani
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Nikvar
- Department of Pharmacology, Islamic Azad University, Science and Research Branch, Tehran, Iran
| |
Collapse
|
6
|
Dhull V, Passah A, Rana N, Arora S, Mallick S, Kumar R. Paraneoplastic pemphigus as a first sign of metastatic retroperitoneal inflammatory myofibroblastic tumor: 18 F-FDG PET/CT findings. Rev Esp Med Nucl Imagen Mol 2016. [DOI: 10.1016/j.remnie.2015.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
7
|
Wang X, Zhao X, Chin J, Zhu L, Wang Z, Zhong Z. Recurrent retroperitoneal inflammatory myofibroblastic tumor: A case report. Oncol Lett 2016; 12:1535-1538. [PMID: 27446466 DOI: 10.3892/ol.2016.4767] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 06/07/2016] [Indexed: 01/25/2023] Open
Abstract
Inflammatory myofibroblastic tumor (IMT), which was previously known as inflammatory pseudotumor, is characterized by myofibroblastic spindle cells accompanied by inflammatory infiltrates. IMT is a rare lesion of unclear etiology, which induces non-specific clinical symptoms. The present case report describes a 74-year-old female patient with recurrent IMT, which was successfully re-resected 30 months subsequent to initial surgical removal. The patient presented with left hydroureteronephrosis and a 10-cm paravertebral mass which, upon surgery, was found to involve the descending colon. Successful, complete en bloc re-resection was achieved, and at 24 months follow-up, the patient remained clinically free of disease. Complete surgical extirpation, where feasible, is the recommended treatment for primary and recurrent IMT lesions.
Collapse
Affiliation(s)
- Xinjun Wang
- Department of Urology, Zhongshan Hospital, Xiamen University, Xiamen, Fujian 361004, P.R. China
| | - Xiaokun Zhao
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Joseph Chin
- Department of Surgery, Division of Urology, London Health Sciences Centre, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Liang Zhu
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Zijian Wang
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | - Zhaohui Zhong
- Department of Urology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| |
Collapse
|
8
|
Mohammad Hoseini-Azar M, Mokhtare M, Zare-Mirzaie A, Gholami A, Agah S, Ghafoori SMS. Fever,Weight Loss and Early Satiety due to Gastric Inflammatory Myofibroblastic Tumor; Case Report and Literature Review. Middle East J Dig Dis 2016; 8:138-42. [PMID: 27252821 PMCID: PMC4885613 DOI: 10.15171/mejdd.2016.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Gastric inflammatory myofibroblastic tumor (IMT) is a rare tumor with and
unpredictable prognosis usually find in young adults. We present an 18-yearold
man with gastric IMT. He complained of epigastric pain, intermittent fever
and night sweating associated with weight loss since two years ago. Physical
examination showed anemic and cachestic features with mild abdominal tenderness
in palpitation as well as an abdominal mass in epigastrium. Abdominal
CT scan revealed a huge mass that was arising from the stomach. Upper endoscopy
revealed a submucosal lesion in fundus of stomach of approximately
8cm. Endoscopic ultrasound showed a large sub-mucosal non homogenous
fundal mass with areas of calcification. The patient underwent laparoscopic
partial gastrectomy. Histopathologyand immunohistochemistryevaluation revealed
an IMT.
Collapse
Affiliation(s)
| | - Marjan Mokhtare
- Assistant Professor, Colorectal Research center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zare-Mirzaie
- Associate Professor,Department of Pathology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Gholami
- Assistant Professor,Department of Internal Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shahram Agah
- Professor, Colorectal Research center, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Sadegh Ghafoori
- Medical student, Colorectal Research center, Medical Student Research Committee (MSRC), Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
9
|
Dhull VS, Passah A, Rana N, Arora S, Mallick S, Kumar R. Paraneoplastic pemphigus as a first sign of metastatic retroperitoneal inflammatory myofibroblastic tumor: (18)F-FDG PET/CT findings. Rev Esp Med Nucl Imagen Mol 2016; 35:260-2. [PMID: 26740314 DOI: 10.1016/j.remn.2015.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 11/30/2022]
Abstract
A 30-year-old female presented with a 3-month history of erosive stomatitis and bullous lesions, along with recurrent episodes of abdominal pain. She was found to have a retroperitoneal lump in left lumbar region. Skin biopsy revealed bullous disorder. CT guided biopsy of the retroperitoneal mass was suggestive of inflammatory myofibroblastic tumor (IMT). She was started on oral steroids and supportive care, and surgery was being planned when she developed respiratory failure. CT chest revealed vertebral metastases. PET/CT for whole body work up revealed a left para-aortic mass along with multiple skeletal metastases. The patient was kept on conservative management. After 3 months, the patient has shown clinical improvement, and an exploratory laparotomy is now being planned for the excision of the tumor, followed by chemotherapy. This case of retroperitoneal IMT is rare in terms of skeletal metastases with paraneoplastic pemphigus.
Collapse
Affiliation(s)
- V S Dhull
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - A Passah
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - N Rana
- Department of Radiodiagnosis, M S Ramaiah Medical College, Bengaluru, India
| | - S Arora
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - S Mallick
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - R Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
10
|
Chen WC, Jiang ZY, Zhou F, Wu ZR, Jiang GX, Zhang BY, Cao LP. A large inflammatory myofibroblastic tumor involving both stomach and spleen: A case report and review of the literature. Oncol Lett 2014; 9:811-815. [PMID: 25624905 PMCID: PMC4301536 DOI: 10.3892/ol.2014.2761] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 11/12/2014] [Indexed: 12/12/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare, benign neoplasm that most commonly occurs in pediatric patients; it has been described as a pseudosarcomatous proliferation of spindled myofibroblasts mixed with lymphoplasmacytic cells. IMT has been reported in a number of locations throughout the body; however, cases occurring in the gastrointestinal tract are rare and to date, no case involving both the stomach and spleen has been reported. The current study presents a case of an extremely large IMT invading both the stomach and spleen in a 50-year-old female, presenting with a three-month history of left-sided abdominal distension without abdominal pain, fever or vomiting. As the tumor had invaded the stomach and spleen, it was completely excised and concomitantly, the entire stomach and spleen were removed. Histological examination of the biopsy revealed fascicles of spindle cells in a mixed inflammatory background, with inflammatory cells that were immunopositive for vimentin, smooth muscle actin, and negative for anaplastic lymphoma kinase and CD30, confirming the diagnosis of IMT. Four months following local excision of the mass, accompanied by a total gastrectomy and splenectomy, no abdominal distension, abdominal pain, fever or vomiting were observed and no IMT recurrence was identified.
Collapse
Affiliation(s)
- Wen-Chao Chen
- Department of General Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Zhen-Yu Jiang
- Department of General Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China ; Department of General Surgery, Qing Chun Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Fan Zhou
- Department of General Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Zheng-Rong Wu
- Department of General Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Gui-Xing Jiang
- Department of General Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Bu-Yi Zhang
- Department of Pathology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Li-Ping Cao
- Department of General Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| |
Collapse
|
11
|
Masciocchi C, Lanni G, Conti L, Conchiglia A, Fascetti E, Flamini S, Coletti G, Barile A. Soft-tissue inflammatory myofibroblastic tumors (IMTs) of the limbs: potential and limits of diagnostic imaging. Skeletal Radiol 2012; 41:643-9. [PMID: 21946938 DOI: 10.1007/s00256-011-1263-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 07/06/2011] [Accepted: 08/21/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this work was to evaluate the potential of diagnostic imaging in the identification, localization, and characterization of soft-tissue inflammatory myofibroblastic tumors (IMTs) of limbs with correlation to differential diagnosis and therapy. MATERIALS AND METHODS From a retrospective analysis of 324 histologically verified soft-tissue lesions of limbs and extremities diagnosed in our institute from January 2002 to July 2010, we selected seven cases of histologically proven IMT. These included six males and one female, aged between 28 and 81 years (mean age, 57 years). Lesions were localized in three cases to the thigh, in two cases to the popliteal space, and in the remaining two cases, to the shoulder girdle. All patients were evaluated on the basis of US, CT, and MRI. RESULTS Ultrasound detected the presence of a non-homogeneous solid formation in all cases and calcifications in three cases. CT showed the presence and type of calcification/ossification and bone reaction. On MRI, all cases had low signal intensity on SE T1-weighted sequences and an intermediate-low signal intensity on SE and FSE T2-weighted sequences in six of them; only one case had an intermediate-high signal intensity on SE and FSE T2-weighted sequences. Both contrast-enhanced CT and MRI showed precocious enhancement in association with multiple peripheral hypertrophic blood vessels. CONCLUSIONS On the basis of integrated imaging data obtained by US, CT, and MRI, it is possible to evaluate the lesion extension to provide a loco-regional staging, to characterize IMTs, and to allow an optimal therapeutical planning.
Collapse
Affiliation(s)
- Carlo Masciocchi
- Department of Radiology, University of L'Aquila, S. Salvatore Hospital, Coppito, 67100, L'Aquila, Italy
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Malignant Transformation of Retroperitoneal Inflammatory Pseudotumor to Undifferentiated High-Grade Pleomorphic Sarcoma on FDG PET/CT. Clin Nucl Med 2012; 37:484-5. [DOI: 10.1097/rlu.0b013e31823eac76] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
13
|
Inflammatory myofibroblastic tumor of the small bowel mesentery: an unusual cause of abdominal pain and uveitis. J Gastrointest Surg 2011; 15:584-8. [PMID: 21207180 DOI: 10.1007/s11605-010-1408-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 12/08/2010] [Indexed: 01/31/2023]
Abstract
INTRODUCTION An inflammatory myofibroblastic tumor (IMT) of the small bowel mesentery with diffuse immunohistochemical staining for the anaplastic lymphoma kinase 1 gene is reported in a patient who presented with abdominal pain and uveitis. DISCUSSION To our knowledge, only seven cases of IMT affecting the small bowel mesentery have previously been reported in the English literature. The association of IMT and uveitis is a rare phenomenon, previously reported in patients with IMT affecting the head and neck. Surgical resection of the IMT resulted in rapid resolution of the uveitis. CONCLUSION IMT should be considered in the differential diagnosis for a mesenteric mass.
Collapse
|
14
|
Dedifferentiated Liposarcoma With Inflammatory Myofibroblastic Tumor-like Features. Am J Surg Pathol 2010; 34:844-51. [DOI: 10.1097/pas.0b013e3181db34d8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|