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Kinkopf P, Bowen RC, Laurenti K. Ocular inflammatory myofibroblastic tumor in a pediatric patient. J AAPOS 2024; 28:103821. [PMID: 38242228 DOI: 10.1016/j.jaapos.2023.10.008] [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] [Received: 08/17/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 01/21/2024]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm that rarely metastasizes and is more commonly seen in children, adolescents, and young adults than older adults. These tumors, composed of myofibroblasts and inflammatory cells, are often confused for a local infection due to the inflammatory cell infiltration, and they form in mucosal surfaces but rarely arise in the orbit. We present the case of a 6-year-old girl with excisional biopsy-confirmed conjunctival stromal IMT. There was no evidence of recurrence 2 years following resection with no subsequent medical therapy.
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Affiliation(s)
- Paul Kinkopf
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Randy Christopher Bowen
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Kelly Laurenti
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Ophthalmology, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Singh M, Saini M, Chatterjee D, Mehta A, Kaur M, Gupta P. Inflammatory myofibroblastic tumour of the conjunctiva masquerading as ocular surface squamous neoplasia. Eur J Ophthalmol 2020; 32:1120672120973611. [PMID: 33222521 DOI: 10.1177/1120672120973611] [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]
Abstract
A 63-year-male had painless, progressive, yellowish-pink, immobile conjunctival mass with prominent feeder vessels in the right eye of 1-year duration. The rest of the ophthalmic examination was unremarkable. MRI showed no extension into orbit or extraocular muscles. An excision biopsy with the amniotic membrane patch was performed. Histopathology confirmed inflammatory myofibroblastic tumour (IMT) with SMA and calponin positivity on immunohistochemistry. Complete surgical excision, amniotic membrane, and oral steroids provided long-term relief from recurrence. The conjunctiva is a rare site for IMT, and IMT should be kept in the differentials for atypical cases of ocular surface neoplasia.
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Affiliation(s)
- Manpreet Singh
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manu Saini
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aditi Mehta
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manpreet Kaur
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Gupta
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Callaway NF, Fisher O, Dubovy S, Bhatia R, Wester ST. Inflammatory myofibroblastic tumour presenting as a medial eyelid mass in a child. Can J Ophthalmol 2018; 53:e241-e244. [PMID: 30503004 DOI: 10.1016/j.jcjo.2018.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/04/2018] [Accepted: 01/09/2018] [Indexed: 11/28/2022]
Affiliation(s)
| | - Oliver Fisher
- University of Miami Miller School of Medicine, Miami, Fla
| | - Sander Dubovy
- University of Miami Miller School of Medicine, Miami, Fla
| | - Rita Bhatia
- University of Miami Miller School of Medicine, Miami, Fla
| | - Sara T Wester
- University of Miami Miller School of Medicine, Miami, Fla.
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Boudhas A, Allaoui M, El Asri F, Rharrassi I, El Ochi MR, Tbouda M, Chahdi H, Al Bouzidi A, Oukabli M. Inflammatory myofibroblastic tumor of the lacrimal gland: case report of an exceptional location. BMC Clin Pathol 2017; 17:12. [PMID: 28824333 PMCID: PMC5561625 DOI: 10.1186/s12907-017-0050-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/11/2017] [Indexed: 12/30/2022] Open
Abstract
Background Inflammatory myofibroblastic tumour (IMT) is a mesenchymal neoplasm of intermediate biological potential that may affect a wide range of anatomic sites but has a particular predilection for the lung and intra-abdominal soft tissues. Case presentation We report here an exceptional case of inflammatory myofibroblastic tumor arising in the lacrimal gland and presenting as an orbital mass in a 24-year-old male. Conclusion This report aims to discuss the importance of histopathological and immunohistochemical findings in arriving at the diagnosis, which helps dictate the management, treatment and prognosis of the patient.
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Affiliation(s)
- Adil Boudhas
- Department of Pathology, Military General Hospital Mohammed V, Mohammed V- Souissi University, Hay Riad, Postal code 10000 Rabat, Morocco
| | - Mohamed Allaoui
- Department of Pathology, Military General Hospital Mohammed V, Mohammed V- Souissi University, Hay Riad, Postal code 10000 Rabat, Morocco
| | - Fouad El Asri
- Department of Ophthalmology, Military General Hospital Mohammed V, Mohammed V- Souissi University, Rabat, Morocco
| | - Issam Rharrassi
- Department of Pathology, Military General Hospital Mohammed V, Mohammed V- Souissi University, Hay Riad, Postal code 10000 Rabat, Morocco
| | - Mohamed Reda El Ochi
- Department of Pathology, Military General Hospital Mohammed V, Mohammed V- Souissi University, Hay Riad, Postal code 10000 Rabat, Morocco
| | - Mohamed Tbouda
- Department of Pathology, Military General Hospital Mohammed V, Mohammed V- Souissi University, Hay Riad, Postal code 10000 Rabat, Morocco
| | - Hafsa Chahdi
- Department of Pathology, Military General Hospital Mohammed V, Mohammed V- Souissi University, Hay Riad, Postal code 10000 Rabat, Morocco
| | - Abderrahmane Al Bouzidi
- Department of Pathology, Military General Hospital Mohammed V, Mohammed V- Souissi University, Hay Riad, Postal code 10000 Rabat, Morocco
| | - Mohamed Oukabli
- Department of Pathology, Military General Hospital Mohammed V, Mohammed V- Souissi University, Hay Riad, Postal code 10000 Rabat, Morocco
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Kiratli H, Uzun S, Varan A, Akyüz C, Orhan D. Management of anaplastic lymphoma kinase positive orbito-conjunctival inflammatory myofibroblastic tumor with crizotinib. J AAPOS 2016; 20:260-3. [PMID: 27312965 DOI: 10.1016/j.jaapos.2016.01.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/13/2016] [Indexed: 11/25/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a distinct mesenchymal neoplasm of myofibroblastic spindle cells associated with an inflammatory infiltrate formed by lymphocytes, eosinophils, and plasma cells in a myxoid or collagenous stroma. This tumor has a predilection for children and young adults and most commonly occurs in the lungs, retroperitoneum, abdomen, and pelvis. Ocular and orbital involvement is exceedingly rare. We describe a case of IMT in a 7-year-old girl involving the cornea, conjunctiva, and the anterior orbit treated with crizotinib, resulting in complete tumor remission.
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Affiliation(s)
- Hayyam Kiratli
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey.
| | - Salih Uzun
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey
| | - Ali Varan
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey
| | - Canan Akyüz
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey
| | - Diclehan Orhan
- Hacettepe University School of Medicine, Sihhiye, Ankara, Turkey
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Ocular Inflammatory Myofibroblastic Tumor in the Left Eye with Phthisis Right Eye: A Rare Occurrence in a Child. Case Rep Ophthalmol Med 2015; 2015:281528. [PMID: 26557400 PMCID: PMC4628688 DOI: 10.1155/2015/281528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/28/2015] [Accepted: 10/04/2015] [Indexed: 11/17/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a benign pseudoneoplastic inflammatory condition with the potential for persistent local growth and recurrence that rarely affects the orbit. We report a very rare case of anterior orbital IMT in a child who presented with gradually progressive mass in left eye for 16 months. Ocular examination showed a cauliflower like exophytic mass at 360 degrees of the perilimbal area covering the entire cornea and obscuring the visualization of anterior and posterior segments. The right eye was phthisical. CT scan showed a lobulated exophytic soft tissue mass in the preseptal region and along the anterior portion of the left globe extending from medial canthus to the lateral canthus. Enucleation of the left eye was performed and the histopathological examination confirmed the diagnosis of IMT. This report aims to raise awareness about this rare ocular entity and emphasizes its early treatment as delay can result in loss of the eye.
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Romero-Rojas AE, Diaz-Perez JA, Mastrodimos M, Szelezsan J, Messa-Botero O. Primary intraocular inflammatory myofibroblastic tumor with anaplastic lymphoma kinase overexpression. Int Ophthalmol 2013; 34:667-73. [DOI: 10.1007/s10792-013-9845-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 08/14/2013] [Indexed: 11/25/2022]
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Infantile Inflammatory Myofibroblastic Tumor of the Orbit With Apical Bone Involvement. Ophthalmic Plast Reconstr Surg 2013; 29:e44-6. [DOI: 10.1097/iop.0b013e3182696922] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Chow SP, Nastri A, Hardy T. Infratemporal inflammatory myofibroblastic tumour with orbital extension. Clin Exp Ophthalmol 2010; 38:727-30. [DOI: 10.1111/j.1442-9071.2010.02329.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Favini F, Resti AG, Collini P, Casanova M, Meazza C, Trecate G, Ferrari A. Inflammatory myofibroblastic tumor of the conjunctiva: response to chemotherapy with low-dose methotrexate and vinorelbine. Pediatr Blood Cancer 2010; 54:483-5. [PMID: 19890966 DOI: 10.1002/pbc.22342] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is an unusual entity that mainly affects children and young adults, and for which standardized therapies for inoperable cases are still lacking. We report on a 12-year-old patient with an extremely rare and inoperable conjunctival location that was treated with chemotherapy using low-dose methotrexate plus vinorelbine, achieving complete tumor remission. This regimen is usually well tolerated and may be considered as the treatment of choice for cases of unresectable advanced IMT.
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Affiliation(s)
- Francesca Favini
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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Is radical surgery necessary to head and neck inflammatory myofibroblastic tumor (IMT) in children? Childs Nerv Syst 2009; 25:285-91. [PMID: 18830608 DOI: 10.1007/s00381-008-0718-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Indexed: 02/05/2023]
Abstract
PURPOSE We report a case of head and neck inflammatory myofibroblastic tumor (IMT) in an infant. Reviewing the literature, we discuss the etiology, diagnosis, treatment, and prognosis of the head and neck IMT in children. MATERIALS AND METHODS A 52-day-old infant was admitted with an enlarging lesion in the right head and neck region. Following total excision, the lesion recurred and progressed to terminal stage. We performed a review of the literature on head and neck IMTs in children up to the age of 18 years and assessed the treatments and related prognosis of IMT in the head and neck region. RESULTS AND CONCLUSIONS The children's prognosis of head and neck IMT is diverse with different treatments. Combined treatment of surgical and corticosteroid is recommended for younger children, especially infants.
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Polito E, Pichierri P, Loffredo A, Moramarco A, Occhini R. Inflammatory Myofibroblastic Tumor of the Orbit. Ophthalmologica 2007; 221:353-5. [PMID: 17728559 DOI: 10.1159/000104767] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2006] [Accepted: 02/22/2007] [Indexed: 01/21/2023]
Abstract
The authors describe an unusual case of orbital inflammatory myofibroblastic tumor (IMT) in a 17-year-old patient who presented with a painful exophthalmos of the left eye. After complete surgical excision, the mass was diagnosed as an IMT based on morphological and immunohistochemical features. No tumor recurrence was evident during 28-month follow-up. The authors discuss histopathological and immunohistochemical characteristics and review the literature of orbital IMT.
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Affiliation(s)
- Ennio Polito
- Department of Ophthalmology and Neurosurgery, University of Siena, Siena, Italy
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Abstract
Inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm composed of transformed myofibroblastic spindle cells with infiltration of a large number of inflammatory cells and/or lymphocytes. The etiology of IMT remains unknown. IMT occurs at various sites and often affects young adults and children. IMT of the liver mostly arises in the right lobe of liver. Biopsy, computed tomography (CT) and magnetic resonance imaging (MRI) are beneficial to diagnosis and differential diagnosis. Vimentin, smooth muscle actin (SMA), muscle-specific actin (MSA) are often positive by immunohistochemistry. The prognosis of most patients is favorable after surgery. In this article, we reviewed the overseas and domestic literatures and summarized the advancement of research on the IMT of the liver about etiology, pathogenesis, clinical presentations, imaging feature, histological appearance, immunohistochemical and electron microscopic feature, diagnosis, differential diagnosis and therapy.
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Ahmad SM, Tsirbas A, Kazim M. Inflammatory myofibroblastic tumour of the orbit in a 7-year-old child. Clin Exp Ophthalmol 2007; 35:160-2. [PMID: 17362459 DOI: 10.1111/j.1442-9071.2006.01435.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Inflammatory myofibroblastic tumour (IMT) is a rare low-grade lesion in the spectrum of myofibroblastic tumours. Systemic IMT is a well-described entity, but orbital IMT is extremely uncommon. These tumours are detected incidentally or through site-specific complaints. Their presentation may clinically and radiologically mimic that of a malignant neoplasm, thus necessitating a biopsy. Even with reports of persistence, local recurrence and malignant transformation the overall prognosis remains favourable.
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Affiliation(s)
- Syed M Ahmad
- Department of Ophthalmology, St Luke's Roosevelt Hospital Center, New York, NY 10025, USA.
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