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Yu H, Zhang C, Tong N, Wang X, Wang L, Gong H, Liu X, Zhou Z. Intraocular myofibroblastoma tumour of the ciliary body: a case report and literature review. BMC Ophthalmol 2022; 22:200. [PMID: 35501775 PMCID: PMC9063157 DOI: 10.1186/s12886-022-02411-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 04/18/2022] [Indexed: 11/18/2022] Open
Abstract
Background Inflammatory Myofibroblastoma Tumors (IMTs) are extremely tumour rare in the intraocular. Case presentation A ciliary body tumor was found under slit lamp biomicroscopy in a 55-year-old male first diagnosed with cataract. Then this patient underwent trans-sclera resection via partial lamellar sclerouvectomy and par plans vitrectomy to remove the mass. Hematoxylin and eosin (HE) staining and immunohistochemistry findings showed that the characteristics of the tumor were consistent with IMT. Conclusions We reported a rare case of intraocular IMT, which is confirmed by H&E staining, and IHC positive staining for Vimentin, Desmin and ALK, while negative staining for SMA, S-100, ki-67, CK, CD68, and calponin.
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Affiliation(s)
- He Yu
- Department of Ophthalmology, Qingdao Municipal Hospital, 5 Middle Donghai Road, Shinan District, Qingdao, Shandong, China.,Department of Ophthalmology, Dalian No,3 People's Hospital, No. 40 Qianshan Road,Ganjingzi District, Dalian, Liaoning, China
| | - Caixin Zhang
- Department of Pathology, Qingdao Municipal Hospital, No.5 Donghai Middle Road, Shinan District, Qingdao, Shandong, China
| | - Nianting Tong
- Department of Ophthalmology, Qingdao Municipal Hospital, 5 Middle Donghai Road, Shinan District, Qingdao, Shandong, China
| | - Xiu Wang
- Department of Ophthalmology, Qingdao Municipal Hospital, 5 Middle Donghai Road, Shinan District, Qingdao, Shandong, China
| | - Liangyu Wang
- Department of Ophthalmology, Qingdao Municipal Hospital, 5 Middle Donghai Road, Shinan District, Qingdao, Shandong, China
| | - Huimin Gong
- Department of Ophthalmology, Qingdao Municipal Hospital, 5 Middle Donghai Road, Shinan District, Qingdao, Shandong, China
| | - Xin Liu
- Department of Ophthalmology, Dalian No,3 People's Hospital, No. 40 Qianshan Road,Ganjingzi District, Dalian, Liaoning, China
| | - Zhanyu Zhou
- Department of Ophthalmology, Qingdao Municipal Hospital, 5 Middle Donghai Road, Shinan District, Qingdao, Shandong, China.
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Oh J, Choi JY. Inflammatory Myofibroblastic Tumor of Nasal Septum after Septoplasty: A Case Report. JOURNAL OF RHINOLOGY 2020. [DOI: 10.18787/jr.2020.00318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Inflammatory myofibroblastic tumor is an uncommon tumor composed of myoblasts and various types of inflammatory infiltrates. Inflammatory myofibroblastic tumor is most common in the lungs but can be rarely found in the nasal cavity. Inflammatory myofibroblastic tumor is a rare entity that represents a diverse histologic pattern that can mimic malignant tumors. We report a case of inflammatory myofibroblastic tumor of the nasal septum in a 45-year-old man who presented with a tumor-like lesion of the nasal septum after two rounds of septoplasty.
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Strianese D, Tranfa F, Finelli M, Iuliano A, Staibano S, Mariniello G. Inflammatory myofibroblastic tumor of the orbit: A clinico-pathological study of 25 cases. Saudi J Ophthalmol 2018; 32:33-39. [PMID: 29755269 PMCID: PMC5943919 DOI: 10.1016/j.sjopt.2018.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) is a rare entity characterized by the presence of myofibroblasts and inflammatory cells within a fibrous stroma, which typically occurs in children or young adults. The IMT is considered generally a benign lesion, although about 20% of cases may experience recurrence, and most rarely develop metastasis. Herein, we present the largest series of primary orbital IMT ever reported. PATIENTS AND METHODS The clinical records of 25 patients, collected between the 1995 and 2015, with biopsy-proven diagnosis of orbital IMT were retrospectively reviewed to determine demographic, clinical, radiologic and pathological features, management, and outcome. RESULTS The study included 13 females and 12 male patients, age ranged from 5 to 76 years. Disease onset was in all cases unilateral (25/25), with posterior location (10/25) or extending anterior to posterior (7/25). The most common signs and symptoms were: proptosis (19/25), ptosis (18/25), diplopia (10/25), periocular swelling (9/25), pain (8/25), redness (7/25). All patients underwent to incisional biopsy which included total or subtotal tumor resection avoiding arming of the adjacent structure, followed by systemic steroid therapy (22/25) or radiotherapy (3/25). The disease recurred in 6 (24%) patients who responded to the subsequent therapy. No one developed metastasis or died because of the disease. CONCLUSION IMT is a distinct entity which may occur in the orbit primarily. It should be considered in differential diagnosis in all orbital masses, particularly with onset of acute or subcronic inflammation. Surgical biopsy associated to a partial debulcking of the tumor, avoiding to damage adjacent vital structure may contribute to improve the outcome. Steroid therapy, seems to be the suitable as first line medical therapy, although, as reported in literature, not all cases respond to this treatment regimen. Radiotherapy, may be considered as an alternative therapy. Recurrences occurred in 24% of patients and may be treated with additional surgical resection and a new course of steroid or radiotherapy. No specific pathological features which may correlate with the prognosis have been found in this series.
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Affiliation(s)
| | - Fausto Tranfa
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Napoli – University Federico II di Napoli, Napoli, Italy
| | - Marialuisa Finelli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Napoli – University Federico II di Napoli, Napoli, Italy
| | - Adriana Iuliano
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Napoli – University Federico II di Napoli, Napoli, Italy
| | - Stefania Staibano
- Department of Biomorphological and Functional Science, Napoli – University of Naples Federico II | UNINA, Italy
| | - Giuseppe Mariniello
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, Napoli – University Federico II di Napoli, Napoli, Italy
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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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Habib L, Son JH, Petris C, Kazim M. Spontaneous regression of inflammatory myofibroblastic tumor of the orbit: A case report and review of literature. Orbit 2017; 36:178-182. [PMID: 28306368 DOI: 10.1080/01676830.2017.1279645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Inflammatory myofibroblastic tumor is a rare entity characterized by the presence of myofibroblasts and inflammatory cells within a fibrous stroma. It typically occurs in the pediatric population. The most common site of occurrence is the lung though it has been reported throughout the body. Although rare, it has been reported in the orbit. The clinical course is ill defined in the literature; here we report a case of pediatric IMT with delayed spontaneous regression.
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Affiliation(s)
- Larissa Habib
- a Department of Ophthalmology , Columbia University Medical Center , New York , New York , USA
| | - Jung Hoon Son
- a Department of Ophthalmology , Columbia University Medical Center , New York , New York , USA
| | - Carisa Petris
- b Department of Ophthalmology , University of Missouri , Columbia , Missouri , USA
| | - Michael Kazim
- a Department of Ophthalmology , Columbia University Medical Center , New York , New York , USA
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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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Mudhar HS, Nuruddin M. ALK-1 positive orbital inflammatory myofibroblastic tumour (IMT) associated with prominent numbers of IgG4 plasma cells - a case report. Orbit 2013; 32:321-323. [PMID: 23927068 DOI: 10.3109/01676830.2013.805789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A 14-year-old boy presented with a 2-year history of a supraorbital mass, associated with loss of vision and phthisis. A lack of response to systemic steroids led to an incisional biopsy. This showed a spindle cell lesion with a prominent inflammatory component, with numerous plasma cells. The spindle cells were positive for anaplastic lymphoma kinase (ALK-1). Over 90% of the plasma cells were surprisingly positive for IgG4. The presence of ALK-1 positivity within the spindle cells, coupled with the prominent inflammation indicated a diagnosis of ALK-1 positive inflammatory myofibroblastic tumour (IMT-the neoplastic member of the so called inflammatory pseudotumours). However, the level of IgG4 positivity within the plasma cell population would have otherwise lead to a diagnosis of IgG4 related disease, if the ALK-1 positive spindle cells population was not represented. Recent literature from systemic IMT has alluded to the presence of IgG4 plasma cell positivity in IMT and argues that in the absence of other supporting histological features of IgG4 disease (phlebitis and lymphoid aggregates), as in this case, the presence of IgG4 plasma cells, even in high numbers should not lead to a kneejerk diagnosis of co-existing IgG4 disease. This case report is the first to make this association in the orbit and argues that in the presence of IMT, the IgG4 plasma cells are not necessarily pathogenic.
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Affiliation(s)
- Hardeep Singh Mudhar
- National Specialist Ophthalmic Pathology Service, Department of Histopathology, Royal Hallamshire Hospital , Sheffield, England , United Kingdom and
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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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Fan F, Lei C, Dong-Liang L, Peng S. Inflammatory myofibroblastic tumor mimicking malignant meningioma in the middle cranial fossa: a case report. ACTA ACUST UNITED AC 2012; 27:185-7. [PMID: 23062643 DOI: 10.1016/s1001-9294(14)60054-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INFLAMMATORY myofibroblastic tumor (IMT), also known as inflammatory pseudotumor or plasma cell granulomas, is an uncommon fibro-inflammatory lesion which is composed of inflammatory cells and myofibroblastic spindle cells. Its pathogenesis is still unknown. The tumor commonly occurs in the lung, upper respiratory tract, live, orbit, abdominal membrane, retroperitoneum, and genitourinary tract.It rarely involves the central nerve system, especially the middle cranial fossa. As far as we know, there are no more than 5 reports of IMT that developed in the middle cranial fossa without involving temporal bone. IMT can occur at any age but primarily affects children and young adults. It is difficult to diagnose IMT by clinical and imaging characteristics only. Here we present an 82-year-old female with intracranial IMT arising from the meninges and without involving temporal bone, which was diagnosed as malignant meningioma before operation.
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Affiliation(s)
- Fan Fan
- Department of Neurosurgical Intensive Care Unit,the Affiliated Hospital of Medical College, Qingdao University, Shandong 266003, China
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Barnes LD, Pearce JW, Berent LM, Fox DB, Giuliano EA. Surgical management of orbital nodular granulomatous episcleritis in a dog. Vet Ophthalmol 2010; 13:251-8. [PMID: 20618804 DOI: 10.1111/j.1463-5224.2010.00781.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 27 kg, 6-year-old, male castrated German shorthaired pointer presented to the University of Missouri, Veterinary Teaching Hospital with the complaint of progressive exophthalmia of 2 years duration optical density (OD). Lack of retropulsion OD was noted on physical examination. Anterior segment examination OU and fundic examination OS did not reveal any abnormalities. Examination of the fundus OD revealed focal scleral indentation of the inferior nasal globe. The indentation changed location with globe movement OD. MRI and CT scan revealed a well-circumscribed, approximately 2 cm in diameter mass located caudal and ventral to the affected globe that appeared to communicate with the nictitating membrane with absence of any bony involvement. A modified lateral orbitotomy was recommended and performed to remove the orbital mass and nictitating membrane en-bloc. Histopathology and immunohistochemistry of the mass confirmed a diagnosis of nodular granulomatous episcleritis (NGE). Postoperatively, the dog developed absolute keratoconjunctivitis sicca (KCS). Examples of primary episcleral inflammation in the dog include diffuse episcleritis, NGE, nodular fasciitis, fibrous histiocytoma, proliferative conjunctivitis/keratoconjunctivitis, pseudotumor, and Collie granuloma. The etiology of these episcleral inflammations is presumed to be immune mediated. To our knowledge, this is the first report of NGE affecting the orbital region of a dog. Development of absolute KCS resulting from excision of the nictitating membrane is also supported by this case.
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Affiliation(s)
- Laura D Barnes
- College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
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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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Current world literature. Curr Opin Ophthalmol 2008; 19:435-43. [PMID: 18772678 DOI: 10.1097/icu.0b013e32830d5da2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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