Benign inflammatory pseudotumour of the parotid gland: a case report and literature review

Inflammatory myofibroblastic tumor of the submandibular gland Harboring MSN-ALK gene fusion: A case report and literature review

Inflammatory myofibroblastic tumors (IMTs) are rare lesions with distinct clinical, pathological, and molecular characteristics. IMTs typically arise in the abdominal soft tissues, including the mesentery, omentum, and retroperitoneum, followed by the lungs and mediastinum, and usually affect both children and young adults. Herein, we present a rare case of an IMT in the submandibular gland of a 47-year-old male patient. Microscopically, the tumor displayed an infiltrative growth pattern with diffuse glandular tissue destruction. Their backgrounds revealed characteristic spindles and inflammatory cells. Immunohistochemistry revealed positivity for anaplastic lymphoma kinase (ALK), smooth muscle actin, and calponin in neoplastic cells. The inflammatory cells and some neoplastic cells were positive for CD68. In contrast, negative staining for cytokeratin, desmin, and CD30 was observed. Furthermore, fluorescence in situ hybridization revealed ALK gene rearrangements, and next-generation sequencing detected a moesin (MSN)-ALK gene fusion. This case highlights a rare and unique occurrence of IMT originating from the submandibular gland, which exhibited an MSN-ALK gene fusion.

Computed tomography and magnetic resonance imaging findings of inflammatory myofibroblastic tumors of the head and neck

BACKGROUND

Inflammatory myofibroblastic tumor (IMT) is a rare tumor of mesenchymal origin that commonly occurs in the lung. Because of its non-specific clinical and imaging features, IMT is often misdiagnosed as a malignant tumor. There have been few imaging reports on IMT of the head and neck.

PURPOSE

To analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of inflammatory myofibroblastic tumors (IMTs) of the head and neck.

MATERIAL AND METHODS

Six patients with IMTs of the head and neck confirmed by histopathologic examination were analyzed retrospectively.

RESULTS

The mean patient age was 40 years. The tumor locations in the six patients were as follows: left bridge of the nose (one), right infratemporal fossa (two), and left parotid gland (three). Three patients who underwent CT all had soft tissue masses or nodules and no calcification. Bridge of the nose tumor showed a homogeneous isodense nodule and mild homogeneous enhancement. Infratemporal fossa tumor showed a homogeneous low density mass and intermediate homogeneous enhancement. Left parotid gland tumor showed a heterogeneous, mostly low density mass, and intermediate heterogeneous enhancement. T1-weighted images of the parotid gland tumors were hypointense; the infratemporal fossa tumor was isointense. T2-weighted images were mildly hypointense and of mixed hypo- and isointensity in the two parotid gland tumors; the infratemporal fossa tumor was homogeneously mildly hypointense. Heterogeneous intermediate enhancement was demonstrated in one parotid gland and the infratemporal fossa patients and mild homogeneous enhancement in another parotid gland patient.

CONCLUSION

The imaging features of IMTs of the head and neck are non-specific. An ill-defined, aggressive mass and variable enhancement on CT and MRI may suggest the diagnosis of IMT. IMT should be included in the differential diagnosis of regional tumors.

[Inflammatory myofibroblastic tumour of the tonsil: case report and literature review]

Inflammatory myofibroblastic tumour (inflammatory pseudotumor) is an idiopathic lesion, rare in the head and neck, of unknown aetiology. It is primarily a soft tissue, lung and orbital condition. In the world literature, only two cases with tonsillar disease have been found. We report a case of a 10-year-old girl admitted to our hospital with clinical complaints of pain in the neck region, cough with vomiting, dyspnoea and dyslexia. Clinical examination revealed halitosis and a neoformation dependent on the left tonsil. Bilateral tonsillectomy was performed.