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Yang S, Tang Y, Yuan Z, Zhang J. Inflammatory myofibroblastic tumor in the liver after bone marrow transplantation: case report and literature review. Front Med (Lausanne) 2025; 12:1489399. [PMID: 40224630 PMCID: PMC11986994 DOI: 10.3389/fmed.2025.1489399] [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: 09/01/2024] [Accepted: 02/17/2025] [Indexed: 04/15/2025] Open
Abstract
Introduction Inflammatory myofibroblastic tumor (IMT) is a rare low-grade malignant neoplasm in the liver. Timely diagnosis and treatment of IMT are challenging due to its atypical symptoms and imaging results. Case report We report a 46-year-old woman who presented to our hospital with persistent hyperpyrexia and discomfort in the right upper abdomen for 2 months post bone marrow transplantation. Radiological findings revealed a space-occupying lesion of uncertain nature in the liver. Since the histological examination of the biopsy specimen indicated IMT, she underwent surgical resection. Subsequently, the postoperative pathology confirmed the diagnosis of IMT. The patient's febrile condition subsided after the surgery. A magnetic resonance imaging (MRI) scan performed 8 months later showed no signs of recurrence. Conclusion IMTs are caused by genetic rearrangements. Diagnosing IMT can be challenging especially in this case as we had to differentiate the tumor from inflammatory diseases associated with bone marrow transplantation. Hence, a thorough pathological immunohistochemical examination is required to confirm its diagnosis. Local IMTs should be treated with radical surgical resection. In cases of distant metastasis or incomplete resection cases, chemotherapy, targeted therapy, or immunotherapy can be utilized. Regular follow-up is crucial for improving the patient's survival rate.
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Affiliation(s)
| | | | | | - Jianwen Zhang
- Department of Hepatic Surgery and Liver Transplantation Center, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Meng Y, Xie J, Liang Y, Wu M, Lu Y, Lu Q. Inflammatory myofibroblastic tumor in the liver: a case report. Front Oncol 2024; 14:1349692. [PMID: 38863636 PMCID: PMC11165177 DOI: 10.3389/fonc.2024.1349692] [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: 12/05/2023] [Accepted: 05/14/2024] [Indexed: 06/13/2024] Open
Abstract
Background Hepatic inflammatory myofibroblastic tumor (IMT) is an infrequent tumor with potential malignancy. However, it lacks specific clinical symptoms and usual imaging features. Case presentation A 34-year-old woman had a six-month history of fever and on-and-off pain in the upper right part of her abdomen that lasted for two weeks. Imaging tests revealed a liver mass initially thought to be liver malignancy, but subsequent histopathological examination after liver removal confirmed the diagnosis as hepatocellular inflammatory myofibroblastic tumor (HIMT). Conclusion Hepatic inflammatory myofibroblastic tumor (IMT) is an uncommon growth with vague clinical symptoms and lab results. Surgical removal remains the primary treatment method, resulting in favorable prognostic outcomes.
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Affiliation(s)
- Yinying Meng
- Department of Radiology, Wuzhou Gongren Hospital, Wuzhou, China
| | - Jinlan Xie
- Department of Radiology, Wuzhou Gongren Hospital, Wuzhou, China
| | - Yan Liang
- Department of Radiology, Wuzhou Gongren Hospital, Wuzhou, China
| | - Mulan Wu
- Department of Ultrasound, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| | - Yi Lu
- Department of Pathology, Wuzhou Gongren Hospital, Wuzhou, China
| | - Qian Lu
- Department of Pathology, Wuzhou Gongren Hospital, Wuzhou, China
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Losuwarat K, Luvira V, Thanasukarn V, Tipwaratorn T, Ungarreevittaya P. Inflammatory Myo-Fibroblastic Tumor of the Gallbladder with Multivisceral Involvement: Successful Treatment with Radical Surgery. Case Reports Hepatol 2023; 2023:1909570. [PMID: 37389088 PMCID: PMC10307192 DOI: 10.1155/2023/1909570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/27/2022] [Accepted: 05/22/2023] [Indexed: 07/01/2023] Open
Abstract
Inflammatory myo-fibroblastic tumor (IMT) of the gallbladder is an extremely rare condition. Only seven cases have been reported. All of these were presented either with polyp/mass inside the gallbladder or gallbladder wall thickening, involving just one adjacent organ. We herein present a case of IMT of gallbladder presenting with a huge mass replacing the gallbladder with multiple organ involvement, successfully treated by en bloc multivisceral resection. Moreover, we have compared it with the characteristics of all reported cases of IMT of the gallbladder.
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Affiliation(s)
- Kwanchanok Losuwarat
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Vor Luvira
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Vasin Thanasukarn
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Theerawee Tipwaratorn
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Piti Ungarreevittaya
- Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Shah PA, Babu R, Ramaswamy V, G SK. Inflammatory myofibroblastic tumours of the duodenopancreaticobiliary tract. BMJ Case Rep 2021; 14:e240833. [PMID: 33958358 PMCID: PMC8103835 DOI: 10.1136/bcr-2020-240833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2021] [Indexed: 11/03/2022] Open
Abstract
Inflammatory myofibroblastic tumours (IMTs) are rare benign neoplasms of intermediate malignant potential that are found in the lungs and rarely at extrapulmonary sites common in children and young adults. IMTs tend to be locally invasive and have some amount of metastatic potential as well. We present two cases of IMTs involving the duodenum, pancreas and distal bile duct. The first case presented with extensive involvement of the first three parts of the duodenum and head of the pancreas, while the second presented with a pancreatic and biliary tree involvement. Upon examinations and investigations, these tumours mimicked malignant neoplasms. A Whipple procedure for surgical resection was undertaken in both cases. The histological findings showed fascicles of spindle cells with infiltration of lymphocytes and plasma cells. The inflammatory myofibroblastic tumour was diagnosed based on pathological grounds with immunohistochemistry. Preoperative diagnosis of IMTs is difficult and complete surgical resection is the primary treatment.
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Affiliation(s)
- Pritik A Shah
- Department of Hepato Pancreato Biliary(HPB) Surgery and Liver Transplant, HealthCare Global Enterprises Ltd, Bangalore, Karnataka, India
| | - Raghavendra Babu
- Department of Hepato Pancreato Biliary(HPB) Surgery and Liver Transplant, HealthCare Global Enterprises Ltd, Bangalore, Karnataka, India
| | - Veena Ramaswamy
- Department of Histopathology, Strand Life Sciences, Bangalore, Karnataka, India
| | - Subash K G
- Department of Hepato Pancreato Biliary(HPB) Surgery and Liver Transplant, HealthCare Global Enterprises Ltd, Bangalore, Karnataka, India
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Calvo A, Salas J, Muñoz G, Díez A, de la Vega MC. A case of inflammatory pseudotumour of the gallbladder presenting as a big mass of uncertain behavior. BMC Gastroenterol 2020; 20:282. [PMID: 32838747 PMCID: PMC7446048 DOI: 10.1186/s12876-020-01408-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 08/03/2020] [Indexed: 12/04/2022] Open
Abstract
Background Inflammatory pseudotumour has been used to describe an inflammatory or fibrosing tumoral process of an undetermined cause that may involve a variety of organ systems, including the lungs, spleen, liver, lymph nodes, pancreas and extrahepatic bile duct with potential for recurrence and persistent local growth. In this article, we report a patient with a big mass of uncertain nature and behavior. Case presentation A 60-year-old woman presented with a 1-week history of abdominal pain, fever and jaundice. Six months before she had had right upper quadrant pain that was interpreted as biliary colic. A contrast-enhanced CT scan showed a big mass of soft tissue with diffuse infiltration of the gallbladder, displacement of the transverse colon, hepatic flexure and duodenum. For diagnostic distinction between a chronic inflammatory disease or a neoplasm, exploratory laparotomy was required. Intraoperative exploration disclosed a big mass of hard texture involving the gallbladder, with multiple concrements, hepatoduodenal ligament, right and transverse mesocolon, stomach and duodenum. Cholecystectomy was performed, preserving adjacent organs with macroscopic desmoplastic reaction. Histopathologic examination of the gallbladder showed a spindle cell proliferation with diffuse chronic inflammatory infiltrate of lymphocytes, plasma cells and hyalinized fibrous stroma. No vascular invasion or cellular atypia were evident. Conclusion Inflammatory pseudotumour is a rare condition and diagnostic distinction from a chronic inflammatory disease or other neoplasm is only possible by histopathologic examination. There is a limited number of case reports in the literature indicating tumor location in the gallbladder.
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Affiliation(s)
- Antonio Calvo
- Department of Surgery and Pathology, Puerto Real University Hospital, Cádiz, Spain.
| | - Jesús Salas
- Department of Surgery and Pathology, Puerto Real University Hospital, Cádiz, Spain
| | - Gloria Muñoz
- Department of Surgery and Pathology, Puerto Real University Hospital, Cádiz, Spain
| | - Ana Díez
- Department of Surgery and Pathology, Puerto Real University Hospital, Cádiz, Spain
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Anteby R, Sullivan BJ, Mani M, Golas B. Recurrent metastatic primary inflammatory myofibroblast tumour of the gallbladder following pancreaticoduodenectomy. BMJ Case Rep 2020; 13:13/2/e232861. [PMID: 32047084 DOI: 10.1136/bcr-2019-232861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Inflammatory myofibroblast tumour (IMT) is an uncommon soft tissue tumour with an unpredictable clinical course: mostly benign, occasionally locally aggressive and rarely capable of metastasis. Diagnosed mainly in the mesentery, omentum, retroperitoneum, pelvis and lungs, IMT is extremely rare as a primary gallbladder tumour. Despite improved radiographical capabilities, differentiating the tumour from other more common causes of gallbladder neoplasms necessitates histopathological and immunohistochemistry tests. Once diagnosed, malignant potential should be taken into consideration, striving for an en bloc R0 resection and postoperative long-term follow-up with routine ancillary imaging. The authors present the case of a recurrent primary IMT of the gallbladder, after two surgical treatments, including a pancreaticoduodenectomy. Now 3 years after initial diagnoses the patient is asymptomatic, but has developed local and distant metastases and is being treated with systemic corticosteroid.
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Affiliation(s)
- Roi Anteby
- Division of Surgical Oncology, Mount Sinai Hospital, New York, NY, USA .,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Malary Mani
- Department of Pathology, Mount Sinai Hospital, New York, NY, USA
| | - Benjamin Golas
- Division of Surgical Oncology, Mount Sinai Hospital, New York, NY, USA
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A Rare Presentation of Inflammatory Myofibroblastic Tumor in the Nasolabial Fold. Case Rep Otolaryngol 2019; 2019:3257697. [PMID: 30809407 PMCID: PMC6364106 DOI: 10.1155/2019/3257697] [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: 10/02/2018] [Revised: 12/22/2018] [Accepted: 12/27/2018] [Indexed: 12/27/2022] Open
Abstract
Inflammatory myofibroblastic tumor (IMT) is a benign lesion that occurs most frequently in the soft tissues and viscera. In the head and neck region, the tumor has been reported to occur in the orbit, tongue, nasopharynx, larynx, and paranasal sinuses and the central nervous system. Despite being a benign lesion, it exhibits infiltrative and destructive behaviours, making histopathological examination necessary to confirm the diagnosis. We report the case of a 38-year-old female presented with a right nasolabial fold mass, which was confirmed histologically to be an IMT. Surgical excision of the mass was achieved through a sublabial approach with an uneventful postoperative period. To the best of our knowledge, this is the first reported case of an IMT in the nasolabial fold.
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Park SG, Kim GH, Park HJ, Kahng DH, Lee BE, Park DY. [Case of an Inflammatory Myofibroblastic Tumor of the Duodenum]. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2018; 72:28-32. [PMID: 30049175 DOI: 10.4166/kjg.2018.72.1.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2025]
Abstract
An inflammatory myofibroblastic tumor (IMT) is a rare disease that can occur in a variety of locations, including the lung, orbit, parotid, pleura, and stomach. Despite multiple reports in various organs, a duodenal IMT is rare with limited case reports. We encountered a case of a 49-year-old male with a duodenal IMT. The patient underwent a laparoscopic wedge resection under the impression of a duodenal mesenchymal tumor, such as gastrointestinal stromal tumor, but the final diagnosis was a duodenal IMT. The patient was treated successfully with an oral nonsteroidal anti-inflammatory drug for the residual lesions. He was free of recurrence during the 12 month follow-up period.
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Affiliation(s)
- Sang Gyu Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Gwang Ha Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ho Joon Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Dong Hwahn Kahng
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Bong Eun Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Do Youn Park
- Department of Pathology, Pusan National University School of Medicine, Busan, Korea
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