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Al Shenawi H, Al-Shaibani SA, Al Saad SK, Al-Sindi F, Al-Sindi K, Al Shenawi N, Naguib Y, Yaghan R. An extremely rare case of malignant jejunal mesenteric inflammatory myofibroblastic tumor in a 61-year-old male patient: A case report and literature review. Front Med (Lausanne) 2022; 9:1042262. [PMID: 36425100 PMCID: PMC9679529 DOI: 10.3389/fmed.2022.1042262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/18/2022] [Indexed: 11/03/2023] Open
Abstract
Introduction A mesenteric inflammatory myofibroblastic tumor (IMT) is a rare solid tumor of intermediate malignant potential that affects children, adolescents, and young adults predominantly. IMT is mostly encountered in the lung. We report a case of malignant jejunal mesenteric IMT in a 61-year-old male patient who presented with vague abdominal pain and generalized weakness. CT scan revealed a mesenteric mass displacing the attached jejunum. Surgical resection was curative. Discussion An extensive literature review was performed to update and further analyze the already available data. A total of 35 cases with mesenteric IMT were reported previously. Only five cases of jejunal mesenteric IMT were reported. Mesenteric IMT demands vast effort to reveal the diagnosis due to its vagueness in the clinical presentation. Mesenteric IMT resembles each other in plenty of pathological and immunohistochemical characteristics. Conclusion To the best of our knowledge, this is the first case of malignant jejunal mesenteric IMT in the elderly. Surgical resection was curative.
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Affiliation(s)
- Hamdi Al Shenawi
- Department of Surgery, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | | | - Suhair K. Al Saad
- Department of Surgery, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Fedaa Al-Sindi
- Department of Pathology, King Hamad University Hospital, Busaiteen, Bahrain
| | - Khalid Al-Sindi
- Department of Pathology, King Hamad University Hospital, Busaiteen, Bahrain
| | - Noor Al Shenawi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Yahya Naguib
- Department of Physiology, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Department of Clinical Physiology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Rami Yaghan
- Department of Surgery, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Department of Surgery, Jordan University of Science and Technology, Irbid, Jordan
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Verma R, Saha A, Saha K. Inflammatory Myofibroblastic Tumor of the Mid Common Bile Duct Masquerading as Cholangiocarcinoma. J Gastrointest Cancer 2020; 50:613-616. [PMID: 29453762 DOI: 10.1007/s12029-018-0074-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ritu Verma
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India.
| | - Arpita Saha
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India
| | - Kaushik Saha
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India
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Arslan NC, Goksel S, Asoglu O. Multivisceral resection for synchronous inflammatory myofibroblastic tumors of the lung and stomach. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2019.101355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Torres US, Matsumoto C, Maia DR, de Souza LRMF, D'Ippolito G. Computed Tomography and Magnetic Resonance Imaging Findings of Inflammatory Pseudotumors in the Abdomen and Pelvis: Current Concepts and Pictorial Review. Semin Ultrasound CT MR 2018; 39:220-229. [PMID: 29571557 DOI: 10.1053/j.sult.2017.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The group of inflammatory pseudotumors (IPTs) encompasses a variety of rare neoplastic and nonneoplastic entities described to occur in almost every location in the body and whose clinical features and aggressive imaging findings (varying from infiltrative to mass-forming lesions), frequently mimic those of malignant tumors. The radiologic features of IPTs are variable and nonspecific, the imaging findings depending on the body location and involved organ. Abdominopelvic IPTs are rare and the purposes of this review, therefore, are to familiarize the radiologist with the wide spectrum of computed tomography and magnetic resonance imaging findings of IPTs in various locations throughout the abdomen and pelvis, discussing the imaging features that allow consideration of IPTs in the differential diagnosis of soft-tissue masses within the pertinent clinical setting. Radiologists should be aware of this group of entities, as a preoperative histopathologic diagnosis upon radiological suspicion may help to differentiate IPTs from malignancy and to allow the most appropriate clinical work-up for these patients.
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Affiliation(s)
| | - Carlos Matsumoto
- Grupo Fleury, São Paulo, Brazil; Department of Imaging, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | - Giuseppe D'Ippolito
- Grupo Fleury, São Paulo, Brazil; Department of Imaging, Universidade Federal de São Paulo, São Paulo, Brazil
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Sheng W, He S, Seare WJ, Almutairi A. Review of the progress toward achieving heat confinement-the holy grail of photothermal therapy. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:80901. [PMID: 28776627 PMCID: PMC5544355 DOI: 10.1117/1.jbo.22.8.080901] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 06/23/2017] [Indexed: 06/01/2023]
Abstract
Photothermal therapy (PTT) involves the application of normally benign light wavelengths in combination with efficient photothermal (PT) agents that convert the absorbed light to heat to ablate selected cancers. The major challenge in PTT is the ability to confine heating and thus direct cellular death to precisely where PT agents are located. The dominant strategy in the field has been to create large libraries of PT agents with increased absorption capabilities and to enhance their delivery and accumulation to achieve sufficiently high concentrations in the tissue targets of interest. While the challenge of material confinement is important for achieving “heat and lethality confinement,” this review article suggests another key prospective strategy to make this goal a reality. In this approach, equal emphasis is placed on selecting parameters of light exposure, including wavelength, duration, power density, and total power supplied, based on the intrinsic properties and geometry of tissue targets that influence heat dissipation, to truly achieve heat confinement. This review highlights significant milestones researchers have achieved, as well as examples that suggest future research directions, in this promising technique, as it becomes more relevant in clinical cancer therapy and other noncancer applications.
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Affiliation(s)
- Wangzhong Sheng
- University of California, Laboratory for Bioresponsive Materials, Department of Mechanical and Aerospace Engineering, Materials Science Program, La Jolla, San Diego, California, United States
- University of California, Laboratory for Bioresponsive Materials, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, San Diego, California, United States
| | - Sha He
- University of California, Laboratory for Bioresponsive Materials, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, San Diego, California, United States
- University of California, Laboratory for Bioresponsive Materials, Department of Nanoengineering, La Jolla, San Diego, California, United States
| | | | - Adah Almutairi
- University of California, Laboratory for Bioresponsive Materials, Department of Mechanical and Aerospace Engineering, Materials Science Program, La Jolla, San Diego, California, United States
- University of California, Laboratory for Bioresponsive Materials, Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, San Diego, California, United States
- University of California, Laboratory for Bioresponsive Materials, Department of Nanoengineering, La Jolla, San Diego, California, United States
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Kim KN, Kim DW. Complete resection of a huge hypervascular inflammatory myofibroblastic tumor in right hemithorax after embolization. World J Pediatr 2016; 12:498-500. [PMID: 27286690 DOI: 10.1007/s12519-016-0038-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 02/26/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) is a rare and mostly benign tumor that has the possibility of malignant change. METHODS Radiological findings revealed a huge mass that filled most of the right hemithorax of a 17-monthold female infant. Tumor extirpation was stopped due to massive bleeding and limited exposure of the tumor. Embolization was conducted to obstruct the arteries feeding the mass. Complete resection was performed. RESULTS Histopathologic examination led to the diagnosis of IMT. Postoperative recovery was uneventful. CONCLUSION Hypervascularity of IMT should be considered. Preoperative embolization can be effective to reduce intraoperative blood loss and facilitate the surgical procedure.
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Affiliation(s)
- Kyu-Nam Kim
- Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong gu, Seoul, 133-792, Republic of Korea
| | - Dong-Won Kim
- Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong gu, Seoul, 133-792, Republic of Korea.
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Analysis of clinical features and outcomes for inflammatory myofibroblastic tumors in China: 11 years of experience at a single center. Pediatr Surg Int 2016; 32:239-43. [PMID: 26590817 DOI: 10.1007/s00383-015-3840-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE Inflammatory myofibroblastic tumor (IMT) is a rare benign neoplasm. The purpose of this study was to review the clinical characteristics, imaging and pathological features, and outcomes of children with IMTs from a single center in China. METHODS A retrospective file review was conducted involving 23 cases of pathologically confirmed IMTs treated at the Children's Hospital between April 2003 and April 2014. RESULTS The tumor locations included multiple anatomic sites, as follows: abdomen or pelvis (n = 17); lungs (n = 2); head and neck (n = 1); trunk (n = 1); and extremities (n = 2). The tumors were associated with various clinical presentations. The predominant symptoms included an anemic appearance, fevers, and an asymptomatic mass. Computed tomography scanning showed solid, heterogeneous, well-demarcated masses; the appearance of enhancement was variable. MRI appeared hypointense on T1-weighted images and hypointense or hyperintense on T2-weighted images. Immunohistochemical staining revealed anaplastic lymphoma kinase was negative in 11 of 13 cases tested. One patient quit treatment for the unresectable mass after biopsy and died 2 years later, and another patient with incompletely resection is alive at 30 months following chemotherapy. The remaining 21 cases had complete resections; one patient died due to a recurrence, and the other 20 patients survived and were tumor free. The follow-up ranged from 7 to 141 months, with a mean of 56 months. The 3-year OS was 88 % (95 % CI, 57-97 %). CONCLUSIONS IMT is a benign neoplasm that rarely presents with malignant features. Complete resection is curative in most patients. ALK+ is variable for diagnosis. Close follow-up is necessary for patients who undergo surgical resection.
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Watanabe H, Uruma T, Tazaki G, Tajiri T, Kikuchi R, Itoh M, Aoshiba K, Nakamura H. Remission of ALK-negative primary pulmonary inflammatory myofibroblastic tumor on treatment with clarithromycin: A case report and review of the literature. Oncol Lett 2016; 11:1757-1761. [PMID: 26998073 PMCID: PMC4774465 DOI: 10.3892/ol.2016.4119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 12/23/2015] [Indexed: 01/31/2023] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) belong to an intermediate group of soft-tissue tumors, they are relatively rare but exhibit a wide range of pathologies, from benign to malignant. At present, no standard treatment has been established, however, it is known to be important to determine the grade of malignancy of the tumor, prior to treatment. The present study reports a 73-year-old female patient with no clinical manifestations, who, when examined radiographically at a health check exhibited bilateral thoracic infiltrative shadows and nodular shadows by chest CT. A metastatic tumor or an organizing pneumonia were suspected. Blood examination showed no abnormal findings, and a pathological diagnosis of IMT was given from the histological findings of the tissue extracted by video-assisted thoracic surgery. Histological analysis established the lack of expression of anaplastic lymphoma kinase (ALK1) and immunoglobulin subtype G4 (IgG4). Alteration of the radiological shadows was observed over several weeks, and after concluding that chronic inflammation was worsening the patient's condition, clarithromycin was administered as a long-term macrolide therapy. The IMT decreased in size, and eight months later it had almost resolved. The patient was last reported to be maintaining a stable condition with no relapse. Some IMT cases have malignant pathology, and should be carefully followed-up. However, in the present case, where the IMT is both ALK1-negative and IgG4-negative, its biological immune responsiveness appears to differ from positive cases, and an inflammatory response was predominant. Clarithromycin, has immunomodulatory and anti-inflammatory effects and appeared to be effective in treating the IMT of the patient in the present study.
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Affiliation(s)
- Hidehiro Watanabe
- Department of Respiratory Medicine and Infection Control, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Ibaraki 300-0395, Japan; Department of Respiratory Medicine, Tokai University Hachioji Hospital, Tokai University School of Medicine, Hachioji, Tokyo 192-0032, Japan
| | - Tomonori Uruma
- Department of Respiratory Medicine and Infection Control, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Ibaraki 300-0395, Japan; Department of Respiratory Medicine, Tokai University Hachioji Hospital, Tokai University School of Medicine, Hachioji, Tokyo 192-0032, Japan
| | - Gen Tazaki
- Department of Respiratory Medicine, Tokai University Hachioji Hospital, Tokai University School of Medicine, Hachioji, Tokyo 192-0032, Japan
| | - Takuma Tajiri
- Department of Pathology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Hachioji, Tokyo 192-0032, Japan
| | - Ryota Kikuchi
- Department of Respiratory Medicine and Infection Control, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Ibaraki 300-0395, Japan
| | - Masayuki Itoh
- Department of Respiratory Medicine and Infection Control, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Ibaraki 300-0395, Japan
| | - Kazutetsu Aoshiba
- Department of Respiratory Medicine and Infection Control, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Ibaraki 300-0395, Japan
| | - Hiroyuki Nakamura
- Department of Respiratory Medicine and Infection Control, Ibaraki Medical Center, Tokyo Medical University, Inashiki, Ibaraki 300-0395, Japan
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Li H, Wang DL, Liu XW, Geng ZJ, Xie CM. MRI characterization of inflammatory myofibroblastic tumors in the maxillofacial region. Diagn Interv Radiol 2015; 20:310-5. [PMID: 24808436 DOI: 10.5152/dir.2014.13348] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to investigate the magnetic resonance imaging (MRI) appearance of inflammatory myofibroblastic tumors (IMTs) in the maxillofacial region in order to improve diagnostic quality and resection efficacy. MATERIALS AND METHODS Ten cases of pathologically identified IMTs were analyzed by MRI. The MRI features were examined, including tumor location, tumor shape, tumor margins, and involvement of the surrounding tissues. RESULTS Of ten masses investigated in this study, eight masses were irregular neoplasms with unclear margins and two masses, in the parotid gland, were regular neoplasms with clear margins. Precontrast T1-weighted images of all ten masses exhibited isointense signals compared to the adjacent tissue, while contrast-enhanced T1-weighted images showed strong enhancement. Six masses were hypointense and four masses were slightly hyperintense in T2-weighted images. Involvement of the adjacent structures was observed in eight of ten cases. Meanwhile, two patients experienced intracranial involvement. CONCLUSION IMTs are rare tumors in the maxillofacial region, displaying a number of distinct MRI characteristics. Most importantly, they display low T2 signal intensity and strong enhancement, and they frequently invade surrounding structures. Thus, MRI can improve the accuracy of IMT diagnoses and provide critical information for surgical planning.
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Affiliation(s)
- Hui Li
- State Key Laboratory of Oncology, Guangzhou, China; the Medical Imaging and Minimally Invasive Interventional Center, Cancer Center, Sun Yat-sen University, Guangzhou, China.
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Yagmur Y, Akbulut S, Gumus S. Mesenteric inflammatory pseudotumor: a case report and comprehensive literature review. J Gastrointest Cancer 2014; 45:414-20. [PMID: 25119386 DOI: 10.1007/s12029-014-9642-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE This study aims to provide an overview of the literature on mesenteric/omental inflammatory pseudotumors (IPTs). METHODOLOGY We present a new case of mesenteric IPT. We also conducted a systematic search of the English-language medical literature using PubMed, Medline, Google, and Google Scholar related to mesenteric or omental IPTs. The following search terms were used in various combinations: inflammatory myofibroblastic tumor, IPT, mesentery, and omentum. The search included articles published in the English language between January, 1978 and April, 2014. Studies were excluded if the full text was unavailable or missing information prohibited comparisons. RESULTS A total of 30 reports concerning 36 patients with inflammatory pseudotumors meeting the aforementioned criteria were included. The patients were aged from 10 months to 68 years (mean, 19.98 ± 20.5 years); 12 were female (16.75 ± 16.97 years; range, 10 months to 68 years) and 24 were male (21.6 ± 21.9 years; range, 18 months to 63 years). Detailed clinical and pathologic characteristics of 36 patients with IPTs are provided in Table 1. CONCLUSION IPTs may be definitively diagnosed only by histopathological examination and are most effectively treated by resection with negative surgical borders. No consensus has yet been reached regarding when nonsurgical treatment options are most appropriate in management of these lesions. IPTs often recur locally, while distant metastases are very rare. Postoperative close surveillance is essential to detect recurrences early.
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Affiliation(s)
- Yusuf Yagmur
- Department of Surgery, Diyarbakir Education and Research Hospital, 21400, Diyarbakir, Turkey
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Inflammatory myofibroblastic tumor: an unusual mimicker of childhood intrathoracic tuberculosis. J Pediatr Hematol Oncol 2014; 36:e426-9. [PMID: 24072244 DOI: 10.1097/mph.0000000000000019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Inflammatory myofibroblastic tumors are rare lesions of uncertain etiology that are often difficult to diagnose because of their myriad clinical presentations. Not uncommon, they mimic persistent pneumonia. We report a 4-year-old girl who presented with prolonged pyrexia, weight loss, severe anemia, hepatosplenomegaly, and nonresolving pneumonia. Initial investigations including flexible bronchoscopy and bronchial washing for usual causes of persistent pneumonia, such as tuberculosis and other infections, were negative. Chest computed tomography revealed a well-defined lesion involving the lingula and left upper lobe with extension into the subpleural space. Pleural tap and biopsy was also noncontributory. Thoracoscopic biopsy was suggestive of an inflammatory myofibroblastic tumor. As the lesion was encasing the major vessels, it was considered inoperable. The patient did not respond to steroid therapy and etoricoxib and later succumbed to the illness. This uncommon tumor should be considered in the differential diagnosis of children who presented with unresolving consolidation with pyrexia.
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