1
|
Setiawan D, Sari PP, Adibrata ASP, Nugraha HG, Soetikno RD, Hernowo B. Inflammatory Myofibroblastic Tumor in Bladder with Multiple Vesicocutaneous Fistula in Pediatric Patient: A Rare Case Report. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
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.
Collapse
|
2
|
Balagobi B, Gobishangar S, Ginige A, Gamlaksha D, Sanjeyan J, Suvethini L. Inflammatory myofibroblastic tumour: case report of a rare form of bladder tumour. Int J Surg Case Rep 2022; 92:106786. [PMID: 35158231 PMCID: PMC8850735 DOI: 10.1016/j.ijscr.2022.106786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction and importance Inflammatory myofibroblastic tumour (IMT) is a rare tumour with malignant potential and has been described in many major organs with the most frequent site being the lungs. However, bladder is an extremely rare location. IMT presents a unique diagnostic challenge because of the characteristics it shares with malignant neoplasms. Case presentation Here we report the case of a 47-yearold male who presented with storage lower urinary tract symptoms associated with non-specific lower abdominal pain for one month duration. Contrast-enhanced computed tomography of abdomen and pelvis revealed a 6 cm tumour at the dome and left side anterior wall of the bladder. He underwent laparotomy and partial cystectomy. Histopathology results were consistent with an IMT. Clinical discussion Even though bladder IMT is indolent in course, typical IMTs can be locally aggressive. Due to the lack of specificity in clinical symptoms, it is not easy to arrive at a precise diagnosis before surgery. Hence, the final diagnosis depends on histomorphological features and the immune histochemical profile. Conclusion It can be challenging to distinguish IMT from malignant neoplasms both clinically and histologically. As such, local surgical resection with close follow-up remains the mainstay of treatment for urinary tract IMT. Occurrence of IMT is rarely encountered in the urinary tract. A 47-year old male with urinary bladder tumour was histopathologically revealed to be of IMT type. Tumour was at the dome of the bladder and left side anterior bladder wall abutting the sigmoid colon. The final diagnosis depends on histomorphological features and the immune histochemical profile. Local surgical resection with close follow-up remains the mainstay of treatment for urinary tract IMT.
Collapse
|
3
|
Song D, jiao W, Gao Z, Liu N, Zhang S, Zong Y, Fang Z, Fan Y. Inflammatory myofibroblastic tumor of urinary bladder with severe hematuria: A Case report and literature review. Medicine (Baltimore) 2019; 98:e13987. [PMID: 30608442 PMCID: PMC6344176 DOI: 10.1097/md.0000000000013987] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE Inflammatory myofibroblastic tumor (IMT) is a rare intermediate soft tissue tumor. Rarely occurring in the urinary bladder, MTs is composed of myofibroblast differentiated spindle cells and accompanied by numerous inflammatory cells, plasma cells and/or Lymphocytes. PATIENT CONCERNS A 28-year-old female, with history of 2 cesarean sections 8 years ago and 2 years ago, was admitted to the emergency department for a 7-day ongoing gross hematuria with clots. DIAGNOSES A cystoscopy showed a tumor near the bladder neck, computed tomography (CT) showed a mass and massive blood clots in the bladder. Finally, postoperative pathological examination confirmed a diagnosis of inflammatory myofibroblastic tumor of bladder. INTERVENTIONS The patient was given rehydration and blood transfusion to improve the general condition. Then, emergency transurethral resection of the bladder tumor was performed. OUTCOMES No metastases to lymph nodes and other organs were found, and no tumor progression was revealed during 3-months of follow-up. LESSONS IMTs rarely occur in the urinary bladder. Due to the lack of specificity in clinical symptoms, it's difficult to arrive at a definite diagnosis before operation. Therefore, usually, the final diagnosis depends on histomorphological features and the immunohistochemical profile. Further case studies are required to study the biological behavior of this condition.
Collapse
Affiliation(s)
- Daoqing Song
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Wei jiao
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
- Department of Urology, Affiliated Hospital of Qingdao University
| | - Ze Gao
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Ningning Liu
- Institute of Mental Health, Peking University, The Sixth Hospital, Peking University, Beijing
| | - Shimin Zhang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Yuqian Zong
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Zhiqing Fang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Yidong Fan
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| |
Collapse
|
4
|
Mansour-Ghanaei F, Gharibpoor A, Joukar F, Mavaddati S, Askari K, Askari SA, Gharibpoor F. Inflammatory Myofibroblastic Tumors in a Case with Hypogastric Discomfort. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:217-221. [PMID: 28250406 PMCID: PMC5344281 DOI: 10.12659/ajcr.901813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patient: Male, 68 Final Diagnosis: Inflammatory myofibroblastic tumor Symptoms: 2–3 kg weight loss • Helicobacter pylori positive which were eradicated after treatment course • hypogastric region discomfort • no association between the pain, defecation and eating • no history of HIV, diabetes, smoking and alcohol consumption was recorded • no symptoms of nausea, vomiting, fever and shaking chills • normal vital signs • tenderness in the right lower quadrant of the abdomen with no rebound state was noted Medication: — Clinical Procedure: Lab examinationt-imaging-colonoscopy-surgery Specialty: Gastroenterology and Hepatology
Collapse
Affiliation(s)
- Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Gharibpoor
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Caspian Digestive Diseases Research Center (CDDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Sara Mavaddati
- Caspian Digestive Diseases Research Center (CDDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Kourosh Askari
- Department of Pathology, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyed Ali Askari
- Caspian Digestive Diseases Research Center (CDDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Faeze Gharibpoor
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| |
Collapse
|
5
|
Inflammatory Myofibroblastic Tumor of the Bladder: 2 Rare Cases Managed with Laparoscopic Partial Cystectomy. Case Rep Urol 2016; 2016:4976150. [PMID: 27974989 PMCID: PMC5126425 DOI: 10.1155/2016/4976150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 10/18/2016] [Indexed: 11/24/2022] Open
Abstract
Two cases of inflammatory myofibroblastic tumor (IMT) of the bladder are reported here. Both patients were male and presented with macroscopic hematuria; in the first case terminal hematuria was associated with irritative voiding symptoms. The second case was a smoker with hematuria unresponsive to medical treatment and anemia. Clinical presentation, pathological features, treatment, and prognosis are discussed. Due to rarity of this pathological condition, there are no guidelines concerning treatment and follow-up. We present our follow-up scheme and highlight the use of laparoscopic partial cystectomy as a successful treatment approach.
Collapse
|
6
|
Etani T, Naiki T, Nagai T, Iida K, Ando R, Naiki-Ito A, Kawai N, Tozawa K, Mizuno K, Okada A, Mogami T, Yasui T. Inflammatory Myofibroblastic Tumor of the Urinary Bladder: A Case Report. Case Rep Oncol 2016; 9:464-469. [PMID: 27721769 PMCID: PMC5043250 DOI: 10.1159/000448550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 07/20/2016] [Indexed: 11/19/2022] Open
Abstract
An inflammatory myofibroblastic tumor (IMT) is a distinctive neoplasm composed of myofibroblastic and fibroblastic spindle cells, accompanied by inflammatory infiltration of plasma cells, lymphocytes, and eosinophils. IMTs rarely occur in the urinary bladder. It is important to distinguish this tumor from other malignant spindle cell tumors. Herein, we report a patient with an IMT showing muscle invasion, who underwent a transurethral resection of the bladder tumor and, at a later date, partial cystectomy. The resected tumor specimen revealed a proliferation of spindle-shaped cells on a background of plasma cells and lymphocytes. Immunohistochemical staining showed the tumor to be positive for anaplastic lymphoma kinase (ALK), smooth muscle actin, and vascular endothelial growth factor (VEGF). Such histopathological findings were indicative of an IMT, suggesting the use of inhibitors of ALK and VEGF as pharmacotherapy.
Collapse
Affiliation(s)
- Toshiki Etani
- Department of Urology, JA Mie Komono Kosei Hospital, Komono, Japan; Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Taku Naiki
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Takashi Nagai
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Keitaro Iida
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Ryosuke Ando
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Aya Naiki-Ito
- Department of Experimental Pathology and Tumor Biology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Noriyasu Kawai
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Keiichi Tozawa
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Kentaro Mizuno
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Atsushi Okada
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| | - Tohru Mogami
- Department of Urology, JA Mie Komono Kosei Hospital, Komono, Japan
| | - Takahiro Yasui
- Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Nagoya City, Japan
| |
Collapse
|
7
|
Abstract
Inflammatory myofibroblastic tumor (IMT) is an uncommon lesion with variable clinical behaviors from benign to mimicking malignant tumors. On rare occasions, IMT may exhibit malignant transformation, and the strategy of malignant IMT is remained undetermined. Herein, we report an extremely unusual case of IMT with malignant transformation of the urinary bladder in a 14-year-old boy characterized by local aggressive behavior and was successfully treated by combined surgery and perioperative chemotherapy.
Collapse
|
8
|
Fuller TW, Dangle P, Reese JN, Ristau BT, Lyon TD, Jaffe R, Stephany HA. Inflammatory myofibroblastic tumor of the bladder masquerading as eosinophilic cystitis: case report and review of the literature. Urology 2015; 85:921-3. [PMID: 25817116 DOI: 10.1016/j.urology.2015.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 12/20/2014] [Accepted: 01/05/2015] [Indexed: 11/17/2022]
Abstract
A 9-year-old boy presented with gross hematuria of 2 days duration. Cystoscopic evaluation revealed an anterior bladder mass. Pathology was consistent with eosinophilic cystitis, and a steroid regimen was initiated accordingly, but no improvement ensued. Concern for alternate malignant pathology led to open resection and the ultimate diagnosis of inflammatory myofibroblastic tumor of the bladder. Inflammatory myofibroblastic tumor is a rare tumor of the bladder in children and to our knowledge has not previously been associated with a misleading eosinophil-rich mucosal inflammatory response.
Collapse
Affiliation(s)
- Thomas W Fuller
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA.
| | - Pankaj Dangle
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Jeremy N Reese
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Benjamin T Ristau
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Timothy D Lyon
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Ronald Jaffe
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Heidi A Stephany
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, PA
| |
Collapse
|
9
|
Navinan MR, Liyanage I, Herath S, Yudhishdran J, Shivanthan C, Beneragama D, Kulatunga A. Inoperable inflammatory myofibroblastic tumour of the para-nasal sinuses and orbit with recurrence responding to methotrexate and prednisolone: a case report. BMC Res Notes 2015; 8:27. [PMID: 25648655 PMCID: PMC4323114 DOI: 10.1186/s13104-015-0993-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 01/23/2015] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Inflammatory myofibroblastic tumour is a rare neoplasm with a potential to behave in a malignant manner. It can occur anywhere in the body, however involvement of the head, especially the para-nasal sinuses is rare. CASE PRESENTATION A 33-year-old South Asian male presented with coryzal symptoms including a persistent cough with an asymmetrical swelling of the left side of the face. Imaging revealed a mass lesion involving the para-nasal sinuses eroding into the orbit. Histology and the clinical picture were compatible with inflammatory myofibroblastic tumour. As curative excision of the tumour was not feasible, medical management was offered. Despite early features of remission to glucocorticoids, tapering resulted in recurrence. Hence combination therapy with glucocorticoids and methotrexate was commenced with dramatic reduction of tumour burden and the patient has been in remission to date. CONCLUSION Inflammatory myofibroblastic tumour has the potential to behave in a malignant manner. Medical management with chemotherapy, glucocorticoids and non-steroidal anti-inflammatory drugs though effective, do not have a uniform response pattern. Surgically unresectable inflammatory myofibroblastic tumour above neck should be treated aggressively with combination regimens. Combination of prednisolone with methotrexate has been shown to have good outcome.
Collapse
Affiliation(s)
| | | | | | | | | | - Dulani Beneragama
- Department of Pathology, Faculty of Medicine, University of Sri Jayawardenepura, Colombo, Sri Lanka.
| | | |
Collapse
|
10
|
Machioka K, Kitagawa Y, Izumi K, Kitamura S, Ikeda H, Namiki M. Inflammatory myofibroblastic tumor of the urinary bladder with benign pelvic lymph node enlargement: a case report. Case Rep Oncol 2014; 7:571-5. [PMID: 25232329 PMCID: PMC4164060 DOI: 10.1159/000366269] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) rarely occur in the urinary bladder. It is apparently difficult to distinguish these tumors from other malignant spindle cell proliferations. Herein, we report a case of IMT of the urinary bladder with enlarged pelvic lymph nodes. The definitive pathological diagnosis could not be established by biopsy. Instead, the diagnosis of IMT of the urinary bladder was determined by a positive reaction to anaplastic lymphoma kinase by immunohistochemistry after radical cystectomy. No malignant findings were observed on histopathological evaluations of the enlarged lymph nodes.
Collapse
Affiliation(s)
- Kazuaki Machioka
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Yasuhide Kitagawa
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Kouji Izumi
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Seiko Kitamura
- Division of Pathology, Kanazawa University Hospital, Kanazawa University, Kanazawa, Japan
| | - Hiroko Ikeda
- Division of Pathology, Kanazawa University Hospital, Kanazawa University, Kanazawa, Japan
| | - Mikio Namiki
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| |
Collapse
|