Inflammatory myofibroblastic tumor of urinary bladder with severe hematuria: A Case report and literature review

Inflammatory myofibroblastic tumor of the bladder turn malignant: A case report

INTRODUCTION AND IMPORTANCE

Inflammatory myofibroblastic tumor (IMT) of the bladder is a rare sight, which can be distinguished by the proliferation of spindle cells and the presence of a persistent chronic inflammatory infiltrate. IMT is usually benign, but in a few cases it has a tendency for malignant transformation and metastases.

CASE PRESENTATIONS

A 30-year-old male with a history of recurrent hematuria. His initial symptoms was unfrequent painless hematuria. Abdomen multislice computerized tomography (MSCT) with contrast shows an enhancing solid mass with necrotized center measuring +/- 12.9 × 16.5 × 18.9 cm and extending from cavum pelvis to cavum abdomen. Cystectomy and bilateral ureterocutaneostomy were performed. The histology report found an IMT with mitotic cells, a necrotic region, and a positive ki67, which suggest the tumor's malignant transformation. Unfortunately, the patient's overall condition continued to deteriorate, and he passed away seven days after hospital discharge.

CLINICAL DISCUSSIONS

IMT is comprised of spindel cells and inflammatory cells. IMT might become aggressive locally, recurring, or progress to malignancy. Fifty percent of IMTs are caused by rearrangements of the anaplastic lymphoma kinase (ALK) gene on chromosome 2p23, resulting in ALK-1 overexpression. A change from uniform spindled cells to atypical polygonal cells or plump cells with oval vesicular nuclei, prominent nucleoli, and mitoses is indicative of malignant transformation.

CONCLUSION

This case emphasizes the importance of continuous monitoring and raising awareness about the possibility of malignant transformation of IMT. Understanding the characteristics of the findings could result in better decision-making and outcomes.

Case report: Emergency management of spontaneous rupture of the inflammatory myofibroblastic tumor of the urinary bladder

Acute abdomen caused by spontaneous rupture of the inflammatory myofibroblastic tumor of the urinary bladder (IMTUB) is a rare clinical emergency of the urinary system.It is difficult to distinguish it from spontaneous rupture of bladder caused by other causes before surgery. An emergency case of spontaneous rupture of IMTUB was reported. A 57-year-old middle-aged woman was admitted to the hospital because of “acute lower abdominal pain for 5 hours”. No history of smoking and gross hematuria. The physical examination revealed visible abdominal tenderness as well as signs of shock. A pelvic CT scan shows a space-occupying lesion above the bladder with massive accumulation of blood. When the nature of the tumor could not be determined, emergency laparotomy and partial cystectomy were performed, and postoperative pathology confirmed cystitis myofibroblastic tumor. No local recurrence or distant metastasis of the tumor was observed during the regular follow-up period of 6 months. IMTUB should focus on prevention and treatment, with a combination of preoperative examination and postoperative pathology, and finally implement highly individualized treatment.

Inflammatory Myofibroblastic Tumor in Bladder with Multiple Vesicocutaneous Fistula in Pediatric Patient: A Rare Case Report

Inflammatory myofibroblastic tumor (IMT) is a rare tumor that occurs at any age from childhood to late adulthood and may have a slight male predilection. A 7-year-old female presented with gross hematuria and a lump in the lower abdomen since 1 month prior to admission. The complaints were also accompanied by weight loss, abdominal pain and anemia. Ultrasound examination, Cystography, CT-Scan and MRI showed that mass in the bladder. Histopathology examination confirmed diagnosis for IMT, thus, radiology plays an important role in supporting histologic examination for diagnosis and evaluation of IMT.

Inflammatory Myofibroblastic Tumor of the Urinary Bladder: An 11-Year Retrospective Study From a Single Center

Purpose

To share our experience in the diagnosis and treatment of an inflammatory myofibroblastic tumor of the urinary bladder (IMTUB).

Materials and Methods

A database searches in the pathology archives by using the term “inflammatory myofibroblastic tumor” and” bladder” in our hospital department of pathology from 2010 to 2021. Patient characteristics, clinical features, histopathological results, immunohistochemical staining results, and treatment outcomes were reviewed.

Results

Fourteen cases of IMTUB were retrieved. The mean age was 44.7 ± 18.9 years (range 12–74). Nine (64.3%) of the patients presented with hematuria, followed by seven (50%) with odynuria, five (35.7%) with urgent urination, and one (7.1%) with dysuria. Ten (71.4%) of the patients were treated with partial cystectomy (PC), three (21.4%) with transurethral resection of bladder tumor (TURBT), and one (7.1%) with radical cystectomy (RC). Histopathologically, eight (57.1%) had a compact spindle cell pattern. Anaplastic lymphoma kinase (ALK) staining was positive in six (75%) of 8 cases. During a mean follow-up period of 43.9 ± 38 months (range 3–117), a patient had recurrence within half a month. Then, the patient was treated with further TURBT surgery and had no recurrence within 6 months. Thirteen of the patients had no local recurrence or distant metastasis.

Conclusion

Inflammatory myofibroblastic tumor of the urinary bladder (IMTUB) is clinically rare and has a good prognosis. The disease is mainly treated with surgery to remove the tumor completely. It can easily be misdiagnosed as bladder urothelial carcinoma, leiomyosarcoma, or rhabdomyosarcoma, which may result in overtreatment and poor quality of life of patients.

Inflammatory myofibroblastic bladder tumor: A very rare presentation

Inflammatory myofibroblastic tumor (IMT) is a rare benign lesion with similarities to malignant lesions due to possible aggressive behavior. Although highly uncommon, this condition usually occurs in lungs and retroperitoneum. The involvement of the genitourinary tract represents a singular occasion. May present with nonspecific manifestations such as painless hematuria, dysuria, voiding urgency and low abdominal pain. We describe a Case of a 55-year-old patient who presented to the urology service complaining of hematuria. Imaging studies showed a 62mm lesion on the upper right side of the bladder and the diagnosis of IMT was confirmed by immunohistochemical evaluation after laparoscopic partial cystectomy.

A case of inflammatory myofibroblastic tumor of the urinary bladder with emergency clinical symptoms similar to bladder cancer

A 55-year-old man was admitted for ongoing gross hematuria and bladder tamponade. Computed tomography revealed a mass near the right sidewall of the bladder, along with massive blood clots. The patient was diagnosed as having bladder cancer based on laboratory findings and emergency clinical symptoms. Thus, emergency transurethral resection of the bladder tumor was performed. Pathological examination revealed an inflammatory myofibroblastic tumor (IMT). No tumor progression was observed during the 6-month follow-up period. Owing to its rarity, IMT has not been well characterized clinically and radiologically, and thus, it is very difficult to diagnose IMT accurately without pathological examinations.

A rare noncancerous but life-threatening tumor in urinary bladder

IMT is a rare but sometimes life-threatening tumor. Although presenting with muscle invasion, local surgical resection with TURBT and close follow-up are adequate with bladder function and life quality preservation compared to partial cystectomy.

Imaging findings of infectious and inflammatory diseases of the urinary system mimicking neoplastic diseases

Neoplastic diseases affecting the urinary organs are common, and diagnosis by imaging is usually straightforward. However, infectious/inflammatory processes also commonly affect these organs and can be mistaken for a neoplasm. Familiarity with these potential mimickers and awareness of their imaging presentations are key for correct diagnosis. We present the imaging findings of non-neoplastic infectious/inflammatory diseases that can mimic a neoplastic process.

Kidney inflammatory myofibroblastic tumor masquerading as metastatic malignancy: A case report and literature review

BACKGROUND

Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor that is characterized by spindle cells differentiated from muscle fibroblasts and infiltration of various types of inflammatory cells. IMT can occur at any age and at any anatomic site. The most common location of IMT is the bladder in the genitourinary tract. Only scarce cases of kidney IMT have been reported in the literature.

CASE SUMMARY

A 77-year-old woman, with a history of bilateral renal calculus for 15 years, was admitted to the Department of Urology of our hospital complaining of recurrent painless gross hematuria for one month. The treatment with cephalosporin was ineffective. Computed tomography imaging showed a mixed density and slightly heterogeneously enhanced lesion in the middle pole of the left kidney and ipsilateral adrenal enlargement. The patient underwent surgical treatment by retroperitoneoscopic left radical nephrectomy plus adrenalectomy. A large number of typical spindle cells surrounded by plasma cells and lymphocytes were observed microscopically. Immunohistochemical analyses indicated that these spindle cells were positive for vimentin, cytokeratin (CK), Ki-67, CK7, CD34, and CD31 and were focally positive for CD10 and anaplastic lymphoma kinase (ALK-1). Thus, a diagnosis of IMT was made definitively. The patient recovered well after operation, and no recurrence or metastasis was noted during the 22-mo follow-up.

CONCLUSION

Since kidney IMT is very rare and lacks characteristic clinical manifestation, it is easily misdiagnosed as a malignant tumor before operation. Surgery remains the best choice for diagnosis and treatment, and such cases must be followed carefully because of the uncertain biological behavior of this tumor. This report suggests that renal calculus may be one of the causes of IMT, but further investigation is necessary to prove it.

Transurethral Resection for the Treatment of an Inflammatory Myofibroblastic Tumor of the Urinary Bladder: A Case Report

Inflammatory myofibroblastic tumors (IMT) of the urinary bladder is a remarkably rare bladder tumor. To this day, no standardized treatment protocol has been recognized. Here we report a case of bladder IMT in a 14-year-old girl presenting with urgency, frequency, and gross painless hematuria for a week. Complete excision of the bladder IMT was amenable with transurethral resection of bladder tumor (TURBT). Follow-up cystoscopy did not detect any recurrence. Minimally invasive bladder-sparing treatments are a valid option for treating IMT of the bladder.