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Ramamourthy B, Arora K, Bal A, Patro SK. Severe Snoring in a Young Healthy Female: A Diagnostic Surprise. Indian J Otolaryngol Head Neck Surg 2022; 74:5064-5068. [PMID: 36742827 PMCID: PMC9895193 DOI: 10.1007/s12070-021-02724-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/27/2021] [Indexed: 02/07/2023] Open
Abstract
Laryngeal Inflammatory myofibroblastic tumors or plasma cell granulomas are unusual benign lesions. Subglottic laryngeal lesions of various benign and malignant types usually present with acute or chronic stridor and respiratory obstruction features. We describe the first case in the literature where severe snoring was the presenting complaint in a patient of subglottic mass lesion with comfortable breathing during wake hour. A 28 years old female presented with loud snoring and apneic episodes during sleep for three years which showed severe Obstructive Sleep Apnoea (OSA) (AHI, Apnoea- Hypoapnoea Index: 46.5) in polysomnography (PSG) and surprisingly smooth mucosa covered subglottic mass blocking 75% of airway lumen in the laryngoscopic examination. The patient underwent tracheostomy and coblation assisted endoscopic excision, and subsequent histopathology revealed an inflammatory myofibroblastic tumour. She was later decannulated and with no features of sleep apnea post decannulation. Subglottic mass can rarely present with severe snoring and requires solid clinical suspicion for early diagnosis. Hence, subglottic lesion should be one of the differentials for atypical presentations of severe OSA.
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Affiliation(s)
- Balaji Ramamourthy
- Department of Otolaryngology and Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Kanika Arora
- Department of Otolaryngology and Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amanjit Bal
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Sourabha K. Patro
- Department of Otolaryngology and Head and Neck Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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2
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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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3
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Serret Miralles P, Nebot Muro L, Carrera Salas R, Blázquez Mañá C. [Inflammatory myofibroblastic tumour of the vocal cord. A case report and revision of the literature]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2021; 54:182-187. [PMID: 34175030 DOI: 10.1016/j.patol.2019.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/22/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022]
Abstract
Inflammatory myofibroblastic tumour (IMT) is a rare entity that can occur in practically any location. Although it has an increased incidence in infancy and adolescence, cases of IMT in the head and neck are more frequent in adults. We report the case of a 74-year-old male who presented with a two month history of dysphonia. Laryngoscopy and cervical TAC revealed a nodular lesion affecting the anterior half of the left vocal cord. He underwent endoscopic laser cordectomy. Histopathology concluded that the lesion was an IMT. Cases of IMT in the head and neck are infrequent and in the vocal cord extremely rare, with only a few previously reported cases.
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Affiliation(s)
- Paula Serret Miralles
- Servicio de Patologia, Parc Taulí Hospital Universitari, Institut d'Investigació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Barcelona, España.
| | - Laura Nebot Muro
- Servicio de Patologia, Parc Taulí Hospital Universitari, Institut d'Investigació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - Rubén Carrera Salas
- Servicio de Patologia, Parc Taulí Hospital Universitari, Institut d'Investigació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
| | - Carmen Blázquez Mañá
- Servicio de Patologia, Parc Taulí Hospital Universitari, Institut d'Investigació Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Barcelona, España
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4
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Kurien R, Malleshappa V, Thomas M, Paul M K. Sinonasal inflammatory myofibroblastic tumour: a rare entity with diagnostic challenges. BMJ Case Rep 2021; 14:14/1/e238406. [PMID: 33462023 PMCID: PMC7813308 DOI: 10.1136/bcr-2020-238406] [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: 01/21/2023] Open
Abstract
Inflammatory myofibroblastic tumour is a rare entity causing sinonasal involvement with variable behaviour. Mimicking various benign and malignant lesions, accurate diagnosis is often clinched on histopathology complemented with appropriate immunohistochemistry markers. Surgical resection is the main treatment modality with other forms of therapy reserved for unresectable lesions. We highlight a case of dual involvement of the sinonasal region and nasal bones along with the diagnostic and treatment challenges encountered. As the nasal bones were involved, surgical resection with negative margins required cosmetic reconstruction in the same sitting. A costochondral graft helped in achieving cosmetic pleasing results with no recurrence on follow-up.
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Affiliation(s)
- Regi Kurien
- Department of ENT, Christian Medical College, Vellore, India
| | | | - Meera Thomas
- Department of Pathology, Christian Medical College, Vellore, India
| | - Kingsly Paul M
- Department of Plastic Surgery, Christian Medical College, Vellore, India
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5
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Soft Tissue Special Issue: Fibroblastic and Myofibroblastic Neoplasms of the Head and Neck. Head Neck Pathol 2020; 14:43-58. [PMID: 31950474 PMCID: PMC7021862 DOI: 10.1007/s12105-019-01104-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/18/2019] [Indexed: 12/17/2022]
Abstract
Fibroblastic and myofibroblastic neoplasms of the head and neck encompass a group of rare tumor types with often overlapping clinicopathologic features that range in biologic potential from benign to overtly malignant. Even neoplasms with no metastatic potential may provide significant therapeutic challenges in this region due to the unique anatomy of the head and neck. This review will cover the following entities, highlighting important clinical aspects of each neoplasm and then focusing on their characteristic histomorphology, immunophenotype, and molecular alterations: nodular and cranial fasciitis, fibrous hamartoma of infancy, nasopharyngeal angiofibroma, nuchal-type and Gardner fibromas, desmoid fibromatosis, dermatofibrosarcoma protuberans and giant cell fibroblastoma, solitary fibrous tumor, inflammatory myofibroblastic tumor, low-grade myofibroblastic sarcoma, infantile fibrosarcoma, low-grade fibromyxoid sarcoma, and sclerosing epithelioid fibrosarcoma. While some of these neoplasms characteristically arise in the head and neck, others are rarely described in this anatomic region and may therefore be particularly difficult to recognize. Distinction between these entities, however, is crucial, particularly as the molecular pathogenetic basis for these neoplasms are being rapidly elucidated, in some instances allowing for targeted therapeutic approaches.
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Elktaibi A, Benzerdjeb N, Ameur F, Daveau C, Tantot J, Costes Martineau V. A Novel ALK-THBS1 Fusion in a Laryngeal Inflammatory Myofibroblastic Tumour: A Case Report and Literature Review. Head Neck Pathol 2019; 14:454-458. [PMID: 31368077 PMCID: PMC7235104 DOI: 10.1007/s12105-019-01061-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is an uncommon neoplasm most frequently seen in the abdomino-pelvic region and lungs of children and young adults. Laryngeal tumors are rare. We present a case of a 23-year-old patient with a 5 month history of laryngitis and aphonia unresolved by corticotherapy. Laryngoscopy revealed a small, non-ulcerated, subepithelial, polypoid mass arising from the right vocal cord. The diagnosis of IMT with ALK expression was supported by histopathologic and molecular analysis. The THBS1 fusion partner was identified by RNA-sequencing analysis for the first time in a laryngeal IMT. This fusion partner has only been identified in six uterine IMTs thus far. Conservative excision of the lesion yielded excellent functional results for the patient. The voice was preserved and no recurrences were seen after 6 months of follow-up.
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Affiliation(s)
- Abderrahim Elktaibi
- grid.157868.50000 0000 9961 060XDepartment of Pathology, CHU Montpellier, Montpellier, France
| | - Nazim Benzerdjeb
- grid.413852.90000 0001 2163 3825Department of Pathology, CHU Lyon, Lyon, France
| | - Fatima Ameur
- grid.413852.90000 0001 2163 3825Department of Radiology, CHU Lyon, Lyon, France
| | - Clementine Daveau
- grid.413852.90000 0001 2163 3825Department of Surgery, CHU Lyon, Lyon, France
| | - Juliet Tantot
- grid.413852.90000 0001 2163 3825Department of Pathology, CHU Lyon, Lyon, France
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Qian J, Zhu K, Ye J. Ultrasonic Manifestations of Mesenteric Inflammatory Myofibroblastic Tumors in Children. Front Pediatr 2019; 7:39. [PMID: 30891434 PMCID: PMC6411639 DOI: 10.3389/fped.2019.00039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/30/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: To explore the ultrasonic manifestations of mesenteric inflammatory myofibroblastic tumors (IMTs) in children. Methods: Seven patients with mesenteric IMTs were retrospectively analyzed. The ultrasonic manifestations, such as the locations, sizes, morphology, borders, internal echo, blood flow, and metastasis, of the tumors were detected. Results: In all the seven pediatric patients, a solitary lesion was found for the mesenteric IMTs, including five cases in the ileocecal mesentery and two cases in the mesentery of ascending colon. All the single tumors were revealed as irregular hypoechoic masses with uneven internal echoes and enhanced echoes in the surrounding intestine and omentum. Internal blood flow signals were enriched in the tumors. The borders were clear in five cases and unclear in two cases. In addition, two cases had peritoneal effusion and one case had calcified plaques. In the follow-up studies, one of the seven IMT patients had malignant transformation, and one case was transferred to the pelvic cavity. Conclusion: Ultrasonic examination can clearly demonstrate the locations, sizes, morphology, borders, internal echo, blood flow as well as metastasis of the pediatric IMT of the mesentery, having an important clinical application value as an adjunct to computed tomography (CT).
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Affiliation(s)
- Jingjing Qian
- Department of Ultrasound, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kun Zhu
- Department of Pathology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jingjing Ye
- Department of Ultrasound, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Menon SS, Nayak DR, Monappa V, Mathew N. Inflammatory myofibroblastic tumour mimicking a vocal cord polyp. BMJ Case Rep 2018; 2018:bcr-2018-226128. [PMID: 30077984 DOI: 10.1136/bcr-2018-226128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Shalini S Menon
- ENT-Head and Neck Surgery, Kasturba Medical College, Manipal, Karnataka, India
| | - Dipak Ranjan Nayak
- Otolaryngology-Head and Neck Surgery, Kasturba Medical College, Manipal, Karnataka, India
| | - Vidya Monappa
- Pathology, Manipal University Kasturba Medical College Manipal, Manipal, Karnataka, India
| | - Nikhil Mathew
- ENT-Head and Neck Surgery, Manipal University Kasturba Medical College Manipal, Manipal, Karnataka, India
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9
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Tay SY, Balakrishnan A. Laryngeal inflammatory myofibroblastic tumor (IMT): a case report and review of the literature. J Med Case Rep 2016; 10:180. [PMID: 27339455 PMCID: PMC4918124 DOI: 10.1186/s13256-016-0967-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 06/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This case report is interesting as cases of children with laryngeal inflammatory myofibroblastic tumor are not common and previously had been presented as isolated case reports. This is the first case report in Asia describing a laryngeal inflammatory myofibroblastic tumor and its removal using an endoscopic approach. CASE PRESENTATION Our patient is a 12-year-old Malay girl from Singapore who presented with hoarseness without respiratory distress. The initial impression was that of a granuloma or a papilloma. We did a biopsy, which confirmed the histology to be inflammatory myofibroblastic tumor, and a magnetic resonance imaging scan showed a contrast-enhanced lesion. The lesion was excised completely using an endoscopic approach. The child was discharged well on the first postoperative day and she has been on follow-up for a year in the clinic. CONCLUSIONS This report highlights the importance of understanding the differential diagnosis for a child with hoarseness. It is not uncommon for a pediatrician, a general practitioner, and a pediatric otolaryngologist to see a child presenting with hoarseness. In most cases, the diagnosis made would be screamer's nodules, which is commonly seen in children. In a small group, recurrent respiratory papillomatosis form the diagnosis. Over the past few years, the cases of recurrent respiratory papillomatosis have decreased significantly. Laryngeal tumors are not common in children. However, we must maintain a high index of suspicion when we have a child with hoarseness who does not improve with speech therapy and watchful waiting. In such situations, a stroboscope is usually necessary to diagnose the voice problems and to rule out pathological conditions such as laryngeal tumors. If left untreated, the lesion can grow with time and result in a life-threatening airway condition. We also demonstrate our endoscopic technique in this report, and it has proven to be safe with no increased recurrence and much lower morbidity.
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Affiliation(s)
- Sok Yan Tay
- Department of Otolaryngology Head and Neck Surgery, National University Health System, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
| | - Abhilash Balakrishnan
- Department of Otolaryngology, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
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Pierry C, Pérot G, Karanian-Philippe M, Neuville A, Gomez-Brouchet A, Crestani S, Coindre JM. Polypoid laryngeal inflammatory myofibroblastic tumors: misleading lesions: description of six cases showing ALK overexpression. Am J Clin Pathol 2015; 144:511-6. [PMID: 26276782 DOI: 10.1309/ajcpcg8d6jaqbvlg] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVES Laryngeal inflammatory myofibroblastic tumors (IMTs) are rarely reported in the literature but may be underrecognized. To better characterize their features, we report a series of six cases. METHODS The clinicopathologic findings, including immunohistochemistry, fluorescence in situ hybridization (FISH) analysis, and follow-up, were evaluated and a review of the literature was performed. RESULTS These cases presented as small polypoid vocal cord or ventricular band lesions, with a more advanced mean age at diagnosis (49 years) than typically reported in other localizations. Apart from one secondary revision surgery, no complementary treatment and no recurrences were observed. Histologically, various morphologic features were seen. All tumors were spindle cell proliferations on a myxoid background with more or less atypia and significant inflammatory infiltrate. All six cases showed anaplastic lymphoma kinase (ALK) immunohistochemical expression. FISH rearrangement was present in four of six cases. Only two cases were initially diagnosed as IMT. CONCLUSIONS According to our series, laryngeal IMTs are easily misdiagnosed. They have a good prognosis, and ALK immunohistochemistry should be carried out to assess this diagnosis when spindle cell proliferations are observed in this localization.
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Affiliation(s)
- Clémence Pierry
- Department of Biopathology, Institut Bergonié, Bordeaux, France
| | - Gaëlle Pérot
- Department of Biopathology, Institut Bergonié, Bordeaux, France
| | - Marie Karanian-Philippe
- Department of Biopathology, Institut Bergonié, Bordeaux, France
- Université Bordeaux, Bordeaux, France
| | - Agnès Neuville
- Department of Biopathology, Institut Bergonié, Bordeaux, France
- Université Bordeaux, Bordeaux, France
| | - Anne Gomez-Brouchet
- Department of Pathology, Rangueil University Hospital, Toulouse, France; and
| | - Sabine Crestani
- ENT and Maxillofacial Surgery Department, Larrey University Hospital, Toulouse, France
| | - Jean-Michel Coindre
- Department of Biopathology, Institut Bergonié, Bordeaux, France
- Université Bordeaux, Bordeaux, France
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Xing P, Li J, Jin F, Wu Y, Zheng X, Chen B, Yao F, Wei X. Metaplastic breast carcinoma development following surgical resection of an inflammatory myofibroblastic tumor in the right breast: A case report. Oncol Lett 2014; 8:1345-1347. [PMID: 25120721 PMCID: PMC4114583 DOI: 10.3892/ol.2014.2261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 05/29/2014] [Indexed: 11/06/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) are uncommon, mesenchymal lesions, and malignant transformation is extremely rare. The current study presents the case of a 56-year-old female with a rapidly growing mass in the right breast, which was diagnosed as IMT. Immunohistochemically, the mass was positive for smooth muscle actin (SMA) and Ki-67 (positive staining in 30% of the cells), and negative for S-100, cluster of differentiation (CD)34, p63 and cytokeratin. Malignant transformation to metaplastic carcinoma of the spindle-cell type was observed following surgical resection. This metaplastic carcinoma demonstrated positive immunoreactivity for cytokeratin, vimentin, CD34, p63 and Ki-67 (>30%), and was negative for cytokeratin 7, SMA, desmin and S-100. The patient underwent total mastectomy of the right breast, followed by palliative chemotherapy with capecitabine; however, the patient succumbed to the disease after 12 weeks. The unusual case presented in the current study emphasizes the importance of pre-operative examinations to determine the benign or malignant nature of IMTs, which aids in the choice of appropriate surgical procedures.
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Affiliation(s)
- Peng Xing
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Jiguang Li
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Feng Jin
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Yunfei Wu
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Xinyu Zheng
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Bo Chen
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Fan Yao
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Xiaolin Wei
- Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
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He CY, Dong GH, Liu HG. Recurrent laryngeal inflammatory myofibroblastic tumor with positive anaplastic lymphoma kinase mimicking recurrent respiratory papillomatosis: a case report. World J Surg Oncol 2014; 12:54. [PMID: 24602144 PMCID: PMC3996035 DOI: 10.1186/1477-7819-12-54] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 02/19/2014] [Indexed: 12/24/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) of the larynx is an unusual lesion, particularly in the pediatric age group. Laryngeal IMTs in children follow a benign clinical course with reports of only rare recurrences and no metastases. Although anaplastic lymphoma kinase (ALK) has been associated with IMTs, there is only one pediatric laryngeal IMT reported to be ALK-positive with immunohistochemical staining. Here, we present a case of a 10-year-old boy with a laryngeal IMT that recurred four times and was misdiagnosed as recurrent respiratory papillomatosis after the initial three operations. ALK positivity was demonstrated by both immunohistochemical staining and fluorescence in situ hybridization. To the best of our knowledge, this case report is the first to describe a laryngeal IMT that recurred multiple times and was confirmed to be ALK-positive at the molecular level.
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Affiliation(s)
| | | | - Hong-gang Liu
- Department of Pathology, Beijing Tongren Hospital, Capital Medical University, No,1 Dongjiaominxiang Street, Dongcheng District, Beijing 100730, China.
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13
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Inflammatory Myofibroblastic Tumor of the Larynx—A Case Report. J Voice 2014; 28:258-61. [DOI: 10.1016/j.jvoice.2013.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 09/17/2013] [Indexed: 11/24/2022]
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Incidence of pulmonary non-epithelial tumors: 18 years' experience at a single institute. Pathol Res Pract 2014; 210:210-6. [PMID: 24405941 DOI: 10.1016/j.prp.2013.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 10/27/2013] [Accepted: 12/02/2013] [Indexed: 11/23/2022]
Abstract
Primary and metastatic non-epithelial tumors of the lung and pleura (NETs-LP) are presumed to represent a small proportion of pulmonary neoplasm, and their epidemiologic characterization is lacking. Moreover, classification of pulmonary mesenchymal tumor according to 'WHO Classification of Tumors of Lung and Pleura' (2004) is simple and necessary to give a supplementation like new 'WHO Classification of Tumors of Soft Tissue and Bone' (2013). Non-epithelial tumors of the lung and pleura diagnosed from January 1995 to April 2013 were retrospectively reviewed and classified in accordance with 'WHO Classification of Tumors of Soft Tissue and Bone' (2013). Of 681 cases represented in the study, smooth muscle tumor (13.1%) was most common, and tumor of uncertain differentiation (10.5%) and fibroblastic/myofibroblastic tumor (5.7%) were followed. Smooth muscle tumor (12.6%) was the common primary tumor, whereas chondrogenic or osteogenic tumor (21.6%) was common in metastatic ones. Pulmonary vascular sarcoma (n=15) was the most frequent primary pulmonary sarcoma with following synovial sarcoma (n=9) and malignant type of solitary fibrous tumor (n=9). This study is the first trial of epidemiologic investigation in Korea about NETs-LP, indirectly representing their incidence in Korea and northeast Asia, and we hope that this presentation offers guidance in further study of NETs-LP.
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15
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Amin M, Ali R, Kennedy S, Timon C. Inflammatory myofibroblastic tumor of the nose and paranasal sinuses masquerading as a malignancy. EAR, NOSE & THROAT JOURNAL 2012; 91:E1-3. [PMID: 22614559 DOI: 10.1177/014556131209100513] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) of the nose and paranasal sinuses is a rare entity that exhibits a diverse histologic pattern that can mimic malignant tumors clinically and radiologically. We present a case of IMT in an 88-year-old man who presented with an aggressive tumor-like lesion in the nose and paranasal sinuses that had a malignant appearance on radiology. We discuss this tumor's clinicoradiologic resemblance to a malignancy, and we review the treatment options following careful histologic and immunohistochemical analysis.
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Affiliation(s)
- Mohamed Amin
- Department of Otolaryngology-Head and Neck Surgery, St. James's Hospital, Dublin, Ireland.
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16
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Dava CJ, Hajiioannou JK, Terzis A, Bizakis J. An inflammatory pseudotumour of the larynx: a case report and literature review of an unusual tumour. Ecancermedicalscience 2012; 6:273. [PMID: 23056150 PMCID: PMC3464076 DOI: 10.3332/ecancer.2012.273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Indexed: 11/30/2022] Open
Abstract
Background: Inflammatory pseudotumour (IPT) is a rare benign pseudoneoplastic proliferation of unknown etiology, often showing locally aggressive behaviour. Conflicting theories about exaggerated response to injury versus true neoplastic origin have been suggested. Methods: We report a case of laryngeal pseudotumour in a 73-year-old man presenting with hoarseness and slowly progressive dyspnea and a short review of the English language literature on the subject. Results: Management consisted of midline vertical thyrotomy, excision of the tumour, and a temporary tracheotomy. No recurrence observed eight months postoperatively. Conclusions: Laryngeal IPT is extremely rare, and it may easily be misinterpreted as a malignant tumour. Conservative excision and anti-inflammatory therapy are advocated, since its general behaviour is benign.
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Affiliation(s)
- Chaido J Dava
- Department of Otolaryngology, General University Hospital of Larissa, Viopolis, PC 41110, PO Box 1425, Larissa, Greece
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17
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Cremonini A, Ponzoni M, Beretta E, Mari G, Cangi MG, Arrigoni G, Doglioni C. Plasma Cell Granuloma of the Thyroid Gland. Int J Surg Pathol 2011; 20:500-6. [DOI: 10.1177/1066896911431453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study reports a case of plasma cell granuloma of the thyroid gland in a 47-year-old woman, presenting with a right subhyoid mass and a previous diagnosis of Hashimoto thyroiditis dating back to 1988, which was made on a subtotal thyroidectomy. Plasma cell granuloma preferentially involves the lung, with only 18 cases of thyroid gland involvement having been reported to date in the English literature. Thyroid plasma cell granuloma preferentially affects women and classically shows a prominent plasma cell infiltrate embedded in a variable degree of fibrous stroma: only 2 of the reported cases exhibited the morphologic features of inflammatory myofibroblastic tumor. These morphologic features may raise problems in the differential diagnosis with other plasma cell–rich disorders, including infectious diseases and auto(dys)immune conditions, including the recently described “IgG4-related sclerosing disease.” In view of these considerations, a contemporary diagnostic approach to thyroid plasma cell granuloma is therefore discussed here.
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Gutiérrez-Jodas J, Ruiz-Molina I, Jurado-Ramos A, Navarro JCP, Ramirez-Ponferrada R, Solis-Garcia E, Baños EC. Inflammatory myofibroblastic tumor of the subglottis in children—Report of a single case with positive anaplastic lymphoma kinase. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.pedex.2010.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Ong HS, Ji T, Zhang CP, Li J, Wang LZ, Li RR, Sun J, Ma CY. Head and neck inflammatory myofibroblastic tumor (IMT): evaluation of clinicopathologic and prognostic features. Oral Oncol 2011; 48:141-8. [PMID: 22014665 DOI: 10.1016/j.oraloncology.2011.09.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 09/11/2011] [Accepted: 09/13/2011] [Indexed: 12/31/2022]
Abstract
Owing to rarity and awareness deficiency towards inflammatory myofibroblastic tumor (IMT), we sought to review on its clinicopathological features; arising awareness to achieve early diagnosis; exploring prognostic factors and then establishing a treatment protocol. Retrospective study was performed on patients with histological proven IMT between January 2003 and December 2010. Their demographic data, clinical and histological presentations were recorded. Overall survival (OS) and progression-free-survival (PFS) were estimated via Kaplan-Meier method. Cox regression model was applied to determine the significant of prognostic factors. Logistic regression model was established to predict the probability of relapse. A total of 28 patients. Five-year PFS was 65%. Surgical margins primarily and independently determined the survival, followed by size, pseudocapsule of the lesion, intra-lesional necrosis and lastly Ki-67 and ALK overexpression. Logistic model in prediction of relapse was established, with the formula as probability of relapse = 1/(1 + e(-z)) where e = exponential function, z = constant value (3.9) + B*margin + B*size + B*immunohistochemical expression + B*pseudocapsule + B*intra-lesional necrosis. Immunohistochemical overexpression was significant if Ki-67 was strongly expressed with a conditioned ALK overexpression simultaneously. Staining intensity must be at least moderate for those ALK nuclear staining was less than 25%. Weak ALK staining intensity is only significant if nuclear staining was more than 25%. Diagnosis of IMT is achieved via exclusion. Radical resection and obtaining negative margins remains the mainstay of treatment. Both high and moderate-risk groups required post-operative radiotherapy. In low-risk group, post-operative radiotherapy was recommended if the lesion is larger than 5 cm in diameter with a conditioned ALK & Ki-67 overexpression.
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Affiliation(s)
- Hui Shan Ong
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai 200011, PR China.
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Ni C, Xu YY, Zhou SH, Wang SQ. Differential diagnosis of inflammatory myofibroblastic tumour and low-grade myofibroblastic sarcoma: two case reports with a literature review. J Int Med Res 2011; 39:311-20. [PMID: 21672335 DOI: 10.1177/147323001103900134] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Inflammatory myofibroblastic tumour (IMT) and low-grade myofibroblastic sarcoma (LGMS) have similar morpho logical and immunophenotypic features, but LGMS is more malignant than IMT and the treatment requires a wider surgical margin plus post-operative chemotherapy or radiotherapy. To date, only 28 cases of IMT and two cases of LGMS have been reported in the laryngopharynx. Recent studies have suggested that anaplastic lymphoma kinase (ALK) and cytokeratin are important markers for differentiating between the two tumours. Here, two cases involving different myofibroblastic tumours of the larynx are reported. Based on the histological and immunohistochemical results, case 1 was diagnosed as IMT involving the right arytenoepiglottic fold, while case 2 was diagnosed as LGMS involving the epiglottic-glossal surface. There was no recurrence or metastasis in either case after post-operative follow-up (12 and 14 months, respectively). It is difficult to distinguish IMT from LGMS; both morphological and immunohistological analyses are required.
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Affiliation(s)
- C Ni
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Airway obstruction due to inflammatory myofibroblastic tumour of the posterior pharyngeal wall. The Journal of Laryngology & Otology 2011; 125:655-9. [DOI: 10.1017/s0022215110003002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:We report a unique case of inflammatory myofibroblastic tumour of the posterior wall of the hypopharynx.Method:We present the patient's case history, management and histopathological findings. A literature review of all cases localised to the larynx or pharynx is provided and discussed.Results:A 67-year-old man presented with airway obstruction due to a spherical mass in the hypopharynx originating from the posterior pharyngeal wall. The tumour was resected. Histopathological examination revealed an inflammatory myofibroblastic tumour. We found only five previously reported cases with pharyngeal localisation. Further treatment of the patient is described.Conclusion:Inflammatory myofibroblastic tumour of the pharynx is extremely rare. It is regarded as a neoplastic tumour of intermediate biological potential. In cases with extrapulmonary localisation, the incidence of local recurrence can be as high as 25 per cent. Radical surgery is the treatment of choice; no adjuvant therapy is necessary.
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Chen YF, Zhang WD, Wu MW, Ou-Yang D, Zhang Q. Inflammatory myofibroblastic tumor of the head and neck. Med Oncol 2010; 28 Suppl 1:S349-53. [PMID: 21042957 DOI: 10.1007/s12032-010-9729-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 10/14/2010] [Indexed: 11/26/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare benign neoplasm. The aim of this study was to enhance the understanding of head and neck IMT and to improve its diagnosis and management. Clinical features and related treatment of 10 IMT cases were retrospectively analyzed and the literature was reviewed. Tumor sites identified included four in the maxillary space, two in the buccal space, two in the parotid gland, one in the post aurem, and one in the neck. Nine of ten patients received local resection, and one of ten patients received a total maxillectomy. One patient had a local recurrence and died, while the other nine patients had no distant metastases and survived. A computed tomography (CT) exam performed on nine of the ten patients showed that six of these nine cases were heterogeneous in density, while the other three cases were homogeneous. Four cases showed marked heterogeneous enhancement, two cases showed mild heterogeneous enhancement, and three cases showed moderate homogeneous enhancement on contrast-enhanced CT images. The incidence of IMT in the head and neck is low, and local resection is currently the best treatment. A prolonged postoperative follow-up period is necessary for patients with IMT.
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Affiliation(s)
- Yan-Feng Chen
- Department of Head and Neck Surgery, Sun Yat-Sen University Cancer Center, No 651 Dongfeng East Road, Guangzhou, Guangdong, People's Republic of China.
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Cho SI, Choi JY, Do NY, Kang CY. An inflammatory myofibroblastic tumor of the nasal dorsum. J Pediatr Surg 2008; 43:e35-7. [PMID: 19040918 DOI: 10.1016/j.jpedsurg.2008.09.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Revised: 09/12/2008] [Accepted: 09/12/2008] [Indexed: 11/26/2022]
Abstract
Inflammatory myofibroblastic tumor of the nose is an uncommon benign proliferative lesion that clinically mimics a neoplastic process. Our case arose in a 4-year-old girl presenting with a mass in the nasal dorsum. The mass was completely excised without any difficulty under general anesthesia. This tumor is a localized and completely benign lesion. Surgical resection is proper management for this condition.
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Affiliation(s)
- Sung-Il Cho
- Department of Otorhinolaryngology, Chosun University College of Medicine, Kwang-ju 501-824, South Korea
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[Inflammatory myofibroblastic tumor of the larynx]. VOJNOSANIT PREGL 2008; 65:779-82. [PMID: 19024126 DOI: 10.2298/vsp0810779m] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIM Inflammatory myofibroblastic tumor (IMT) of the larynx is a rare borderline lesion composed of myofibroblastic and inflammatory cells. CASE REPORT We presented a case of 77-year-old male with hoarseness for about three months. Laryngoscopy showed a polypoid tumor originated from the anterior commissure with glottic projection. Grossly, the tumor was 22 x 15 mm, whitish, oval nodus with firm consistency. Histologically, the lesion was composed of spindled to stellate cells arranged in a fascicular to storiform pattern and inflammatory cells: lymphocytes, histiocytes, plasma cells and neutrophils. The stroma was fibromyxoid and collagenous. Immunohistochemically, tumor cells showed strong positivity for actin and vimentin and negativity for cytokeratin, CD34, S100 and desmin. The proliferation (Ki67) was less than 10%. CONCLUSION Inflammatory myofibroblastic tumor may be mistaken as a malignancy and the differential diagnosis can be difficult without immunohistochemistry. It is critical to recognize this uncommon entity to avoid unnecessary aggressive treatment.
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