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Wang G, Shen H, Chu Z, Shen J, Zhang L. Intracranial inflammatory myofibroblastic tumor: a report of two cases. Br J Neurosurg 2023; 37:1349-1353. [PMID: 33517794 DOI: 10.1080/02688697.2021.1879011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
We report two cases of Intracranial inflammatory myofibroblastic tumor (IMT) with recurrent, cystic, and venous sinus occlusion. The cases show imaging progression from a small lesion (case 1) or absence of lesions (case 2). One of cases recurred 2 years after surgery and was treated with corticosteroids but the tumor was still growing and was resected again. We think the best treatment for IMT is surgical resection.
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Affiliation(s)
- GengHuan Wang
- Department of Neurosurgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - HePing Shen
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - ZhengMin Chu
- Department of Neurosurgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - JianGuo Shen
- Department of Neurosurgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - LiTao Zhang
- Department of Neurosurgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
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Chandramouli R, Sowmya YS, Raghava Ks A, Gochhait D, Jagadesan P. Inflammatory Myofibroblastic Tumor of the Testis in a Patient With Cecal Carcinoma. Cureus 2023; 15:e44573. [PMID: 37662511 PMCID: PMC10474877 DOI: 10.7759/cureus.44573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2023] [Indexed: 09/05/2023] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) are uncommon tumors that can be classified among fibroinflammatory disorders. IMTs are diagnosed after excluding all other entities, which can be considered differential diagnoses of IMTs. Microscopic examination of IMTs shows multiple myofibroblastic spindle cells, which are surrounded by inflammation. IMTs have lesser chances of progression to malignancy. The case defined below is one of the few cases in the literature that reports the presentation of IMT and another malignancy. We describe a 72-year-old man who was found to have cecal carcinoma and later diagnosed with an IMT of the testis. IMTs are generally benign tumors with a tendency for local recurrence. Patients affected by IMTs usually get diagnosed only after more than one biopsy. IMT is diagnosed only after ruling out other differential diagnoses. They rarely show invasiveness and metastasize. The presence of metastasis, recurrence, and other malignancies probably indicate poor prognosis and poor survival. The course of IMTs is usually benign, with good outcomes after surgery. IMTs have been known to recur, invade, or metastasize in sites such as paranasal sinuses, mediastinum, and the abdomen. In the case that we researched, vimentin and smooth muscle actin were strongly positive in the spindle-shaped cells, whereas anaplastic lymphoma kinase-1 was negative.
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Affiliation(s)
- R Chandramouli
- Radiation Oncology, Krishna Cancer Institute, Cuddalore, IND
| | - Y Sree Sowmya
- Radiation Oncology, Great Eastern Medical School and Hospital, Ragolu, IND
| | | | - Debasis Gochhait
- Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
| | - Pandjatcharam Jagadesan
- Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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Mantilla JG, Cheung H, Ha AS, Hoch BL, Liu YJ, Ricciotti RW. Spindle cell neoplasm with EML4-ALK gene fusion presenting as an intraosseous vertebral mass. Genes Chromosomes Cancer 2020; 60:282-286. [PMID: 33170538 DOI: 10.1002/gcc.22917] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 10/31/2020] [Accepted: 11/04/2020] [Indexed: 01/11/2023] Open
Abstract
In this article, we describe a spindle cell neoplasm harboring an EML4-ALK gene fusion presenting as an intraosseous vertebral mass with extension into the adjacent soft tissue in a 65-year-old man. Histologically, the lesion was characterized by the presence of monotonous, cytologically bland spindle cells with loose myxoedematous stroma and interspersed areas of amianthoid-like collagen fiber deposition. Immunohistochemistry demonstrated strong diffuse staining for CD34 and S100, with absent immunoreactivity for SOX10. At 1 year of follow-up after resection, there is no evidence of local recurrence or metastatic disease. This case adds to the clinical and pathologic spectrum of the recently described group of kinase fusion-positive spindle cell neoplasms and represents the first reported intra-osseous example. The presence of ALK rearrangement in this lesion represents a potential therapeutic target, if clinically indicated.
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Affiliation(s)
- Jose G Mantilla
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Hoiwan Cheung
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Alice S Ha
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | | | - Yajuan J Liu
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Robert W Ricciotti
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
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Atypical Sino-Orbital Inflammatory Myofibroblastic Tumor with Bone and Cerebral Invasion Extending to the Orbit. Eur J Ophthalmol 2018; 24:608-10. [DOI: 10.5301/ejo.5000401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2013] [Indexed: 01/20/2023]
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Lahlou G, Classe M, Wassef M, Just PA, Le Clerc N, Herman P, Verillaud B. Sinonasal Inflammatory Myofibroblastic Tumor with Anaplastic Lymphoma Kinase 1 Rearrangement: Case Study and Literature Review. Head Neck Pathol 2017; 11:131-138. [PMID: 27443585 PMCID: PMC5429268 DOI: 10.1007/s12105-016-0744-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 07/09/2016] [Indexed: 12/27/2022]
Abstract
Inflammatory myofibroblastic tumors (IMTs) are rare mesenchymal tumors initially described in the lung. About half of them exhibit expression of the ALK1 protein, generally resulting from a gene rearrangement. Paranasal sinus IMTs are extremely uncommon, and gene rearrangement of ALK1 is very rare in this localization. A 47-year-old woman presented with rapidly progressive vision loss in her left eye. Clinical and imaging work-up revealed a tumor invading the left ethmoidal and sphenoidal sinuses and extending into the nasal cavity, the orbit and the skull base. Complete tumor resection was performed using an endonasal approach. Pathological examination revealed a paranasal localization of IMT, positive for ALK1 immunostaining. FISH analysis showed an ALK1 gene rearrangement. This case illustrates the local aggressive potential for IMTs. Treatment is primarily surgical, but targeted therapies (crizotinib) might be a solution for ALK1 rearranged cases with a poor prognosis.
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Affiliation(s)
- Ghizlene Lahlou
- ENT Department, Lariboisiere Hospital, 2 Rue Ambroise Paré, 75010, Paris, France.
| | - Marion Classe
- Pathology Department, Lariboisiere Hospital, APHP, Paris 7 University, Paris, France
| | - Michel Wassef
- Pathology Department, Lariboisiere Hospital, APHP, Paris 7 University, Paris, France
| | | | - Nicolas Le Clerc
- ENT Department, Lariboisiere Hospital, 2 Rue Ambroise Paré, 75010, Paris, France
| | - Philippe Herman
- ENT Department, Lariboisiere Hospital, 2 Rue Ambroise Paré, 75010, Paris, France
- EA 7334 REMES, Paris 7 University, Paris, France
| | - Benjamin Verillaud
- ENT Department, Lariboisiere Hospital, 2 Rue Ambroise Paré, 75010, Paris, France
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Tateishi Y, Okudela K, Kawai S, Suzuki T, Umeda S, Matsumura M, Kioi M, Ohashi K. Intraosseous inflammatory myofibroblastic tumor of the mandible with a novel ATIC-ALK fusion mutation: a case report. Diagn Pathol 2016; 11:132. [PMID: 27846861 PMCID: PMC5111215 DOI: 10.1186/s13000-016-0586-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 11/09/2016] [Indexed: 11/29/2022] Open
Abstract
Background Inflammatory myofibroblastic tumor (IMT) is a rare low-grade malignant neoplasm with a predilection for children and young adults, and typically arises in the lung, abdominopelvic region, and retroperitoneum. IMTs in the maxillofacial region are extreme rare. Approximately 50% of IMT harbor rearrangements of the anaplastic lymphoma kinase (ALK) gene at 2p23 with various fusion partners. Case presentation We herein report a case of intraosseous IMT of the mandible with a novel ATIC-ALK fusion. Tooth 43 did not erupt after the loss of tooth 83 in an 11-year-old girl with no previous history of trauma. Panoramic tomography showed a unilocular radiolucent lesion in the right anterior mandible resorbing the root of tooth 42 and the medial side of the root of tooth 44. Computed tomography revealed a well- circumscribed 3-cm osteolytic lesion of the right anterior mandible eroding the buccal cortical plate. The entire lesion was curetted out. A histopathological examination revealed the proliferation of plump spindle cells with a storiform architecture and lymphocytes scattered around spindle cells. The spindle cells showed diffuse cytoplasmic staining for ALK by immunohistochemistry. A fluorescence in situ hybridization analysis revealed the translocation of a part of the ALK gene locus at chromosome 2p23. A rapid amplification of cDNA ends analysis confirmed the rearrangement of ALK and identified ATIC as a partner of this ALK fusion mutant. Conclusion To the best of our knowledge, this is the first case of intraosseous IMT of the mandible with a novel ATIC-ALK fusion. We also herein reviewed similar tumors reported in the literature.
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Affiliation(s)
- Yoko Tateishi
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | - Koji Okudela
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shigeo Kawai
- Department of Pathology, Japanese Red-Cross Musashino Hospital, Tokyo, Japan
| | - Takehisa Suzuki
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shigeaki Umeda
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mai Matsumura
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mitomu Kioi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kenichi Ohashi
- Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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ZHANG TIAN, YUAN YAWEI, REN CHEN, DU SHASHA, CHEN JIARONG, SUN QUANQUAN, LIU ZHENGJUN. Recurrent inflammatory myofibroblastic tumor of the inguinal region: A case report and review of the literature. Oncol Lett 2015; 10:675-680. [PMID: 26622552 PMCID: PMC4509014 DOI: 10.3892/ol.2015.3297] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 04/24/2015] [Indexed: 12/17/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) of the inguinal region are exceptionally rare. The current study reported the case of a 49 year-old male patient with IMT, who presented with a fever, night sweats, anorexia, loss of weight and frequent urination. Computed tomography (CT) revealed a lesion occupying the soft tissue of the right inguinal region and surgery was performed to resect the lesion. Histopathological analysis of the lesion revealed a composition of spindle and inflammatory cells, including plasma cells and lymphocytes. In addition, immunohistochemical analysis demonstrated that the tumor cells were positive for CD34, vimentin, actin, Ki-67, B cell lymphoma-2, CD99, epithelial membrane antigen and CD38; however, tumor cells were negative for CD117, desmin, anaplastic lymphoma kinase and creatine kinase. Thus, the patient was diagnosed with IMT and was advised to return for regular follow-up appointments. Subsequently, the patient developed a local recurrence 12 months following the initial surgery. Of note, the histopathological characteristics of the recurrent lesions were consistent with those of the initial specimen. Thus, a second surgery was performed, followed by fractionated radiotherapy (FRT). At 3 and 6 months following the FRT, magnetic resonance imaging scans did not indicate tumor recurrence or metastasis. In conclusion, surgical excision is the current recommended treatment for IMT; however, for cases similar to that of the current study, which are not successfully controlled by surgical excision, radiotherapy should be considered and long-term follow-up is essential.
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Affiliation(s)
- TIAN ZHANG
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | - YAWEI YUAN
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - CHEN REN
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - SHASHA DU
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - JIARONG CHEN
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - QUANQUAN SUN
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - ZHENGJUN LIU
- Department of Vascular Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
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Intraosseous inflammatory myofibroblastic tumor in the mandible: a rare pathologic case report. Case Rep Surg 2014; 2014:565478. [PMID: 25254136 PMCID: PMC4165562 DOI: 10.1155/2014/565478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 08/20/2014] [Indexed: 02/05/2023] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is an extremely rare lesion found in the maxillofacial region. Its frequency diminishes further when found in the bone. Although classification has varied throughout its history, the histologic features are often diagnostic, particularly with its strong association with anaplastic lymphoma kinase-1 (ALK-1) staining. The current mode of treatment for such a lesion is surgical removal with careful followup. In this rare case report, we describe the diagnosis and treatment in a 16-year-old male. Although this rare pathology can present as—and at times mimic—more serious pathologies, it is important for the attending surgeon to initially manage the pathology conservatively.
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Moon CH, Yoon JH, Kang GW, Lee SH, Baek JS, Kim SY, Kim HR, Kim CH. A case of recurrent pulmonary inflammatory myofibroblastic tumor with aggressive metastasis after complete resection. Tuberc Respir Dis (Seoul) 2013; 75:165-9. [PMID: 24265646 PMCID: PMC3833938 DOI: 10.4046/trd.2013.75.4.165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 07/26/2013] [Accepted: 08/01/2013] [Indexed: 11/24/2022] Open
Abstract
An inflammatory myofibroblastic tumor (IMT) is a rare disease entity reported to arise in various organs. It is thought to be a neoplastic or reactive inflammatory condition, controversially. The treatment of choice for myofibroblastic tumor is surgery, and recurrence is known to be rare. The optimal treatment method is not well-known for patients ineligible for surgery. We report a 47-year-old patient with aggressive recurrent IMT of the lungs. The patient had been admitted for an evaluation of back-pain two years after a complete resection of pulmonary IMT. Radiation therapy was performed for multiple bone recurrences, and the symptoms were improved. However the patient presented again with aggravated back-pain six months later. High-dose steroid and non-steroidal anti-inflammatory drugs were administered, but the disease progressed aggressively, resulting in spinal cord compression and metastasis to intra-abdominal organs. This is a very rare case of aggressively recurrent pulmonary IMT with multi-organ metastasis.
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Affiliation(s)
- Chae Ho Moon
- Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
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Farshad M, Bode B, Min K. Intraosseous Inflammatory Myofibroblastic Tumor of the Twelfth Thoracic Vertebra: Report of a Rare Case with Histological Diagnosis and Surgical Treatment. JBJS Case Connect 2013; 3:e46. [PMID: 29252240 DOI: 10.2106/jbjs.cc.l.00316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Mazda Farshad
- Department of Orthopaedics, University of Zurich, Balgrist University Hospital, Forchstrasse 340, 8008 Zurich, Switzerland.
| | - Beata Bode
- Institute of Surgical Pathology, University Hospital Zurich, Ramistrasse 71, 8006 Zurich, Switzerland
| | - Kan Min
- Department of Orthopaedics, University of Zurich, Balgrist University Hospital, Forchstrasse 340, 8008 Zurich, Switzerland.
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Maire JP, Eimer S, San Galli F, Franco-Vidal V, Galland-Girodet S, Huchet A, Darrouzet V. Inflammatory myofibroblastic tumour of the skull base. Case Rep Otolaryngol 2013; 2013:103646. [PMID: 23573442 PMCID: PMC3614032 DOI: 10.1155/2013/103646] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 02/20/2013] [Indexed: 01/03/2023] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) are rare benign clinical and pathological entities. IMTs have been described in the lungs, abdomen, retroperitoneum, and extremities but rarely in the head and neck region. A 38-year-old man presented with headache, right exophthalmia, and right 6th nerve palsy. A CT scan revealed enlargement of the right cavernous sinus and osteolytic lesions of the right sphenoid and clivus. MR imaging showed a large tumor of the skull base which was invading the sella turcica, right cavernous sinus, and sphenoidal sinus. A biopsy was performed and revealed an IMT. Corticosteroids were given for 3 months but were inefficient. In the framework of our pluridisciplinary consultation, fractionated conformal radiotherapy (FRT) was indicated at a low dose; 20 Gy in 10 fractions of 2 Gy over 12 days were delivered. Clinical response was complete 3 months after FRT. Radiological response was subtotal 6 months after FRT. Two years later, the patient is well.
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Affiliation(s)
- Jean-Philippe Maire
- Department of Radiation Oncology, Saint-André University Hospital, University Bordeaux Segalen, 33076 Bordeaux, France
| | - Sandrine Eimer
- Department of Pathology, Pellegrin University Hospital, University Bordeaux Segalen, Bordeaux, France
| | - François San Galli
- Department of Neurosurgery A, Pellegrin University Hospital, University Bordeaux Segalen, Bordeaux, France
| | - Valérie Franco-Vidal
- Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, University Bordeaux Segalen, Bordeaux, France
| | - Sigolène Galland-Girodet
- Department of Radiation Oncology, Saint-André University Hospital, University Bordeaux Segalen, 33076 Bordeaux, France
| | - Aymeri Huchet
- Department of Radiation Oncology, Saint-André University Hospital, University Bordeaux Segalen, 33076 Bordeaux, France
| | - Vincent Darrouzet
- Department of Otolaryngology and Skull Base Surgery, Pellegrin University Hospital, University Bordeaux Segalen, Bordeaux, France
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Bibliography Current World Literature. CURRENT ORTHOPAEDIC PRACTICE 2013. [DOI: 10.1097/bco.0b013e318280c6c2] [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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