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Hattori T, Tanizawa Y, Shimoda T, Koseki Y, Furukawa K, Fujiya K, Aizawa D, Sugino T, Terashima M, Bando E. Gastric inflammatory myofibroblastic tumor: a case report. Surg Case Rep 2024; 10:62. [PMID: 38485843 PMCID: PMC10940569 DOI: 10.1186/s40792-024-01844-7] [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: 11/16/2023] [Accepted: 02/13/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) of the stomach is an uncommon mesenchymal neoplasm. We present a case of gastric submucosal tumor (SMT) where the final diagnosis was IMT. CASE PRESENTATION A 69-year-old man presented with a 24-mm SMT on the posterior wall of the middle third of the stomach that was detected by screening upper gastrointestinal endoscopy. Abdominal contrast-enhanced computed tomography showed that the tumor was well-enhanced. Although endoscopic ultrasonography-guided biopsy was performed, the histological diagnosis was not confirmed preoperatively. Since the tumor was clinically suspected to be a gastrointestinal stromal tumor, we performed gastric wedge resection by laparoscopic-endoscopic cooperative surgery. Pathologically, proliferative spindle cells with a positive reaction for smooth muscle actin, negativity for c-kit, desmin, s-100, CD34, STAT-6, β-catenin and anaplastic lymphoma kinase 1 were identified. Hence, the tumor was finally diagnosed as an IMT originating from the stomach. CONCLUSIONS When an SMT of the stomach is identified, the possibility of gastric IMT should be considered.
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Affiliation(s)
- Taku Hattori
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Yutaka Tanizawa
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan.
| | - Tadakazu Shimoda
- Divisions of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Yusuke Koseki
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Kenichiro Furukawa
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Keiichi Fujiya
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Daisuke Aizawa
- Divisions of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Takashi Sugino
- Divisions of Pathology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Masanori Terashima
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
| | - Etsuro Bando
- Divisions of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-Cho, Sunto-Gun, Shizuoka, 411-8777, Japan
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Hiramatsu S, Ataka R, Nakayama Y, Hirai M, Hirata A, Takeshima J, Hirai K, Hamasu S, Aoyama I, Hirose T. Gastric inflammatory myofibroblastic tumor presented with severe anemia and inflammation: a case report. Surg Case Rep 2024; 10:5. [PMID: 38185719 PMCID: PMC10772034 DOI: 10.1186/s40792-023-01802-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/24/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) is a rare stromal tumor, often found in children and young adults, and most commonly occurs in the lungs. Surgical resection is considered the standard treatment for localized IMT, although only limited data exist. Gastric IMT in adults is extremely rare, and there are no established guidelines for its treatment. CASE PRESENTATION A 69-year-old male presented with persistent fatigue and weakness. Laboratory examination revealed severe anemia and inflammation. Upper gastrointestinal endoscopy at admission revealed a 40-mm type I softish tumor in the lesser curvature of the gastric body, without apparent hemorrhage. Repeated biopsies, including partial resection with snare, failed to give a definitive diagnosis. Computed tomography (CT) revealed a massive lesion at the gastric body, protruding into the gastric lumen, which was consistent with the gastric tumor. After admission, the patient developed anemia refractory to frequent blood transfusions despite the absence of apparent gastrointestinal bleeding. In addition, the patient had recurrent fevers of 38 °C or higher, and persistent high inflammatory levels. Fluorodeoxyglucose-positron emission tomography (FDG-PET) CT 1 month after the first visit exhibited an increased FDG uptake in the gastric tumor. In addition, this CT scan revealed a rapid increase in tumor size to 75 mm. It was suspected that the undiagnosed gastric tumor caused these serious clinical symptoms, and he underwent distal gastrectomy and cholecystectomy. The gross image of the tumor showed an 80-mm cauliflower-like shape with a gelatinous texture. The histopathological diagnosis was IMT. The postoperative course was uneventful, and the patient's symptoms subsided drastically, improving both anemia and systemic inflammation. The patient has shown no recurrence or relapse of the symptoms over one and a half years. CONCLUSIONS In this case, the tumor resection finally enabled the diagnosis of IMT and resolved the clinical symptoms. Despite its predominantly benign morphological nature, some cases of IMT present clinically adverse courses. Surgical treatment may lead to its final diagnosis and improvement of clinical symptoms.
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Affiliation(s)
- Sakura Hiramatsu
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Ryo Ataka
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan.
| | - Yusuke Nakayama
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Miho Hirai
- Department of Gastroenterology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Ayako Hirata
- Department of Gastroenterology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Jun Takeshima
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Kenjiro Hirai
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Shinya Hamasu
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Ikuo Aoyama
- Department of Gastroenterology, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
| | - Tetsuro Hirose
- Department of Surgery, Otsu Red Cross Hospital, 1-1-35 Nagara, Otsu City, Shiga, Japan
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Kimura N, Hiraki M, Akashi M, Miyahara K, Imamura M, Furukawa S, Samejima R. A rare case of inflammatory myofibroblast tumor of the stomach successfully treated by inverted laparoscopic and endoscopic cooperative surgery. Surg Case Rep 2023; 9:189. [PMID: 37902858 PMCID: PMC10616023 DOI: 10.1186/s40792-023-01767-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/14/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND An Inflammatory myofibroblastic tumor (IMT) is a rare intermediate malignancy characterized by myofibroblast proliferation and inflammatory cell infiltration. Various organs are the primary sites of origin. However, primary tumors originating in the stomach tend to be extremely rare, making the diagnosis difficult. Herein, we present a case of IMT originating in the stomach that was effectively managed using inverted laparoscopic endoscopic cooperative surgery (LECS). CASE PRESENTATION A 47-year-old male who was admitted to the hospital because of a submucosal tumor that was discovered during upper gastrointestinal endoscopy. The diameter of the tumor was approximately 20 mm. A KIT-negative gastrointestinal stromal tumor was suspected based on the biopsy findings. Therefore, partial resection of the stomach was performed using inverted laparoscopic and endoscopic cooperative surgery. Histopathological examination revealed collagen fiber proliferation from the submucosal layer to the muscular layer, accompanied by infiltration of spindle-shaped cells, lymphocytes, and numerous inflammatory cells. Immunohistochemistry results were positive for SMA and negative for CD34, desmin, and c-kit. IgG4-positive cells were observed with an IgG4/IgG ratio > 50%, and specific nuclei were positive for ALK. Therefore, IMT was diagnosed. This condition may be difficult to diagnose both before and after surgery because of its rarity and submucosal tumor-like morphology. CONCLUSION When a submucosal tumor originating in the stomach is observed, IMT should be considered. Partial resection of the stomach with LECS and immunohistochemical diagnosis may be useful.
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Affiliation(s)
- Naoya Kimura
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Masatsugu Hiraki
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan.
| | - Michiaki Akashi
- Department of Pathology, Japan Red Cross Society Karatsu Red Cross Hospital, Karatsu, Saga, Japan
| | - Koichi Miyahara
- Department of Internal Medicine, Japan Red Cross Society Karatsu Red Cross Hospital, Karatsu, Saga, Japan
| | - Minori Imamura
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Shunsuke Furukawa
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
| | - Ryuichiro Samejima
- Department of Surgery, Japan Red Cross Society Karatsu Red Cross Hospital, 2430 Watada, Karatsu, Saga, 847-8588, Japan
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4
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Asbah M, Shrateh ON, Musleh A, Abbadi K, Amro W, Shaltaf A. Huge mesenteric inflammatory myofibroblastic tumor as a rare cause of intussusception with recurrence after 10 months: Case report and literature review. Int J Surg Case Rep 2023; 111:108871. [PMID: 37757735 PMCID: PMC10539857 DOI: 10.1016/j.ijscr.2023.108871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Inflammatory myofibroblastic tumor (IMT) is an infrequent, generally non-cancerous mesenchymal growth. IMT can affect individuals across various age groups, with a higher prevalence in children and adolescents. While it can emerge in any bodily region, it has a tendency to develop more often in the lungs and mesentery. IMT occurrence in the small bowel is exceptionally uncommon. It's a rare cause of intussusception and has unpredictable recurrence rate. CASE PRESENTATION This report highlights a unique clinical presentation involving a mesenteric IMT, which presented as small intestine intussusception in a 2-year-old child. Additionally, the patient was found to have an asymptomatic mass in the right upper quadrant, later identified as a recurrent IMT 10 months after surgical intervention for intussusception caused by the same tumor. CLINICAL DISCUSSION IMTs originate from mesenchymal tissues and encompass a blend of fibroinflammatory conditions. They exhibit a diverse combination of inflammatory and spindle cells. Diagnosing IMTs prior to surgery is intricate, as they can mimic malignant growths. Histopathology following surgery is usually needed for confirmation. Complete removal with a clear margin is the favored treatment approach. CONCLUSION Intestinal IMT is an infrequent and often overlooked condition, but it should be taken into account when diagnosing small bowel intussusception. The best chance of preventing recurrence in cases of intestinal IMT is through complete surgical removal with a negative margin. Nonetheless, the most effective approach for managing local recurrence and metastasis is still uncertain and necessitates ongoing long-term observation.
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Affiliation(s)
- Malvina Asbah
- Department of General Surgery, Palestinian Medical Complex (PMC), Ramallah, Palestine
| | - Oadi N Shrateh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Asil Musleh
- Department of General Surgery, Palestinian Medical Complex (PMC), Ramallah, Palestine
| | - Khaled Abbadi
- Department of General Surgery, Palestinian Medical Complex (PMC), Ramallah, Palestine.
| | - Wael Amro
- Department of Pediatric Surgery, Palestinian Medical Complex (PMC), Ramallah, Palestine
| | - Ahmad Shaltaf
- Department of Pediatric Surgery, Palestinian Medical Complex (PMC), Ramallah, Palestine
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5
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Tong M, Zhang BC, Jia FY, Wang J, Liu JH. Hepatic inflammatory myofibroblastic tumor: A case report. World J Clin Cases 2023; 11:4318-4325. [PMID: 37449218 PMCID: PMC10336984 DOI: 10.12998/wjcc.v11.i18.4318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/15/2023] [Accepted: 05/23/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Hepatic inflammatory myofibroblastic tumor (HIMT) is a rare type of hepatic tumor. It is always misdiagnosed and mistreated because it is primarily found with no obvious specific manifestation, and its imaging findings are diverse.
CASE SUMMARY Here, we report a case of HIMT that was initially diagnosed as liver malignancy but was confirmed as HIMT by histopathology after hepatectomy. Mostly, HIMTs are infiltrated with plasma cells and stain positively for anaplastic lymphoma kinase on immunohistochemistry as well as for some other kinases.
CONCLUSION HIMT can be treated with single nonsteroidal anti-inflammatory drugs and without surgery when it is diagnosed accurately. Because the etiology of HIMT is unknown and the diagnosis is difficult, the pathogenesis and clinical process need to be further studied.
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Affiliation(s)
- Meng Tong
- Department of General Surgery, Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China
| | - Bo-Cheng Zhang
- Department of General Surgery, Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China
| | - Fei-Yu Jia
- Graduate Management Office, Education and Teaching Department, Linyi People’s Hospital, Linyi 276000, Shandong Province, China
| | - Jing Wang
- Department of Radiology, Linyi People’s Hospital, Linyi 276000, Shandong Province, China
| | - Jing-Hua Liu
- Department of Hepatobiliary Surgery and Minimally Invasive Institute of Digestive Surgery and Prof. Cai’s Laboratory, Linyi People’s Hospital, Linyi 276000, Shandong Province, China
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6
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Moges TG, Nureta TH, Mohammed TP. An inflammatory myofibroblastic tumor of the small intestine presenting as jejunojejunal intussusception; A case report. Int J Surg Case Rep 2023; 108:108404. [PMID: 37336176 PMCID: PMC10382734 DOI: 10.1016/j.ijscr.2023.108404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/21/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE An inflammatory myofibroblastic tumor (IMT) is an uncommon solid neoplasm of mesenchymal origin. They are usually seen in children and adolescents and commonly affect the lung, but they can nearly arise from every organ. The prevalence of IMT in the small bowel is very rare. The tumors have generally a benign clinical course, with some risk of local recurrence or distant metastasis. PRESENTATION OF CASE This is a 55-year-old male patient who presented with intermittent abdominal pain, vomiting of ingested matter and loss of appetite for 2 weeks duration. On physical examination, he had stable vital signs and the abdominal examination was non-revealing. Abdominal CT scan with contrast showed a long segment jejunojejunal intussusception. He underwent en-bloc resection of the mass and end-to-end anastomosis of the jejunum. CLINICAL DISCUSSION IMTs have a mesenchymal origin and are grouped into a mixture of fibroinflammatory disorders. They show a variable mix of inflammatory cells with spindle cells. The diagnosis of IMT preoperatively is challenging often mimicking malignant lesions. The diagnosis is often confirmed by histopathology after surgery. Complete excision with a negative margin is the preferred treatment. We report a rare case of jejunal IMT presenting with intussusception. CONCLUSION An intestinal IMT is a rare and an underdiagnosed entity, and should be considered in the differential diagnosis of small bowel intussusception. Surgery is still the most favored and effective treatment for intestinal IMT. Complete surgical excision with a negative margin has the least chance of disease recurrence.
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Affiliation(s)
- Tadesse Girma Moges
- Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Ethiopia.
| | - Tilahun Habte Nureta
- Department of Surgery, Faculty of Medicine, Institute of Health, Jimma University, Ethiopia
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7
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Inflammatory myofibroblastic tumor of the spleen: a case report. Radiol Case Rep 2021; 16:3117-3119. [PMID: 34457099 PMCID: PMC8377435 DOI: 10.1016/j.radcr.2021.07.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 07/07/2021] [Accepted: 07/10/2021] [Indexed: 11/21/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs), otherwise known as the inflammatory pseudotumor, is a rare solid mesenchymal tumor, simulating malignant neoplasms, histologically characterized by the proliferation of spindle cells in a fibrous myxoid stroma containing inflammatory cells. CT and MR imaging are the most used tools in their assessment. Clinical features are nonspecific and depend on the localization of the tumor, radiologic findings are polymorphic and no-conclusive and present a diagnostic challenge to the radiologist. Although histology remains obligatory for the final diagnosis. Heren, we report a case of splenic IMT with histological correlation.
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8
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Wang B, Xu X, Li YC. Inflammatory myofibroblastic tumor of the spleen: a case report and review of the literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:1795-1800. [PMID: 31934000 PMCID: PMC6947135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 03/26/2019] [Indexed: 06/10/2023]
Abstract
Inflammatory myofibroblastic tumor of the spleen (IMTS) is an extremely rare, intermediate malignant tumor with unclear etiology, and is most frequently detected incidentally. IMTS presents with nonspecific symptoms that pose a diagnostic challenge to clinicians or presents with the similar appearances to splenetic malignant neoplasms that pose a misdiagnose prior to surgery. Histopathology of the resected specimen remains the gold standard for diagnosing these rare splenic tumors. But these tumors may be misdiagnosed if pathologists are not familiar with the histologic pattern of their variations. In this paper we report a rare case of IMTS in a 55-year-old female admitted to the Xingtai People's Hospital affiliated to Hebei Medical University, with a mass of the spleen. The mass was identified incidentally two months ago and was initially diagnosed as a splenic lymphoma. The patient underwent laparoscopic splenectomy and the histologic study of the specimen revealed findings consistent with IMTS. Histological examination of the nodular growth revealed spindle cells in a hyalinized stroma with inflammatory infiltration of predominantly plasma cells and lymphocytes, coupled with lymphoid follicle structures. Immunohistochemical staining was performed to confirm the diagnosis of IMTS. Splenectomy is both diagnostic and curative for IMTS, and prognosis is generally favorable following the procedure. Our case report of IMTS adds to pathologists' knowledge of diagnosis. Meanwhile, the description and the review of features of IMTS, based on published cases, should help to improve the understanding and diagnosis level of this rare disease.
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Affiliation(s)
- Bo Wang
- Department of Pathology, Xingtai People’s Hospital Affiliated to Hebei Medical UniversityXingtai, Hebei, P. R. China
| | - Xin Xu
- Department of Pathology, Xingtai People’s Hospital Affiliated to Hebei Medical UniversityXingtai, Hebei, P. R. China
| | - Yong-Cai Li
- Department of Medical Imaging, Xingtai People’s Hospital Affiliated to Hebei Medical UniversityXingtai, Hebei, P. R. China
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9
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Nakanishi M, Watari J, Tomita T, Nakanishi Y, Tsukamoto Y, Matsuo S, Uchihashi T, Miyazaki J, Tanaka H, Kojima S, Kuroda N, Matsuda I, Miwa H, Shinohara H, Hirota S. Gastric CLTC-ALK fusion-positive inflammatory myofibroblastic tumor showing an endoscopic superficial depressed-type appearance. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2018.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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10
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He J, Zhao X, Huang C, Zhou X, You Y, Zhang L, Lu C, Yao F, Li S. Double amplifications of CDK4 and MDM2 in a gastric inflammatory myofibroblastic tumor mimicking cancer with local invasion of the spleen and diaphragm. Cancer Biol Ther 2018; 19:967-972. [PMID: 30252584 DOI: 10.1080/15384047.2018.1480290] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is currently recognized as an intermediate mesenchymal neoplasm. It can arise anywhere in the body, but it is particularly common in the lungs. Gastric IMT is very rare in adults. In this study, we report a case of a 68-year-old woman with IMT in the gastric cardia, with invasion into the spleen and diaphragm. Because of its location and aggressive clinical features, it was first mistaken for gastric cancer. However, pathology and immunohistochemistry were used to finally confirm the diagnosis of IMT after total resection of the tumor and spleen and partial resection of the diaphragm. In order to provide better understanding of this rare tumor, targeted next-generation sequencing (NGS) and IHC were performed to assess genetic and protein abnormalities of the tumor. Both IHC and NGS were found to be negative for ALK or other gene fusions. However, double amplification of CDK4 and MDM2 were found by NGS, and IHC also found CDK4 and MDM2 to be positive. To the best of our knowledge, this is the first gastric IMT report to show double invasion of the spleen and the diaphragm, and double amplification of CDK4 and MDM2 in IMT are also reported for the first time. This genomic aberration with protein overexpression is the most likely tumorigenic driver of this rare and aggressive tumor.
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Affiliation(s)
- Jia He
- a Department of Thoracic Surgery , Peking Union Medical College Hospital , Beijing , China
| | - Xinyi Zhao
- b School of medicine , Tsinghua University , Beijing , China
| | - Cheng Huang
- a Department of Thoracic Surgery , Peking Union Medical College Hospital , Beijing , China
| | - Xiaoyun Zhou
- a Department of Thoracic Surgery , Peking Union Medical College Hospital , Beijing , China
| | - Yan You
- c Department of Pathology , Peking Union Medical College Hospital , Beijing , China
| | - Lu Zhang
- d Medical Department , Burning Rock Biotech , Beijing , China
| | - Chongmei Lu
- e Department of Gastro-intestinal Medicine , Peking Union Medical College Hospital , Beijing , China
| | - Fang Yao
- f Department of Gastro-intestinal Medicine , National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College , Beijing , China
| | - Shanqing Li
- a Department of Thoracic Surgery , Peking Union Medical College Hospital , Beijing , China
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Tregnago AC, Morbeck DL, D’Almeida Costa F, Campos AHJFM, Soares FA, Vassallo J. Inflammatory pseudotumor-like follicular dendritic cell tumor: an underdiagnosed neoplasia. ACTA ACUST UNITED AC 2017. [DOI: 10.1186/s41241-017-0051-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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12
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Lu H, Shen H, Shen XQ, Chen Q, Wu SC, Lv Y. Inflammatory myofibroblastic tumor of the hand: A case report. Oncol Lett 2015; 9:2548-2550. [PMID: 26137104 DOI: 10.3892/ol.2015.3141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 03/13/2015] [Indexed: 12/16/2022] Open
Abstract
The present study reports the case of a 58-year-old male patient who repeatedly presented with hand ulcers that were diagnosed as cellulitis. Upon histological analysis, however, an inflammatory myofibroblastic tumor (IMT) was diagnosed. IMTs rarely occur in the hands. The involved tissue was removed with the tumor, with the exception of the tendons and cutaneous nerve. The involved tendon sheath and epineurium were carefully resected. After 2 years of follow-up, the patient showed no signs of tumor recurrence and the hand function was good. IMTs in the hands are relatively rare, and are often easily misdiagnosed as infection. An early and correct diagnosis is the key to successful treatment. A biopsy is necessary following debridement of the infected lesion, particularly for recurrent infected lesions. The surgical approach should be conservative, in order to maintain maximum hand function.
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Affiliation(s)
- Hui Lu
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Hui Shen
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Xiang-Qian Shen
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Qiang Chen
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Shou-Cheng Wu
- Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Ying Lv
- Department of Neonatology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
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