Pulmonary inflammatory myofibroblastic tumor invading the left atrium

Inflammatory myofibroblastic tumor is a rare solid tumor that most often affects children and young adults. Although benign, the tumor may be very aggressive locally. We describe a 9-year-old boy with primary inflammatory myofibroblastic tumor of the left upper lobe involving the left atrium.     

Inflammatory myofibroblastic tumor of the lung: a benign lesion with aggressive behavior

Inflammatory myofibroblastic tumor is a rare solid tumor that most often affects children and young adults. They present as myofibroblastic cell proliferations accompanied by inflammatory cells made up mostly of plasma cells. Although benign, the tumor may be very aggressive locally. In this report we describe a 22-year-old woman with primary invasive myofibroblastic tumor of the left lower lobe leading to a left pneumonectomy.     

Complete surgical resection of inflammatory myofibroblastic tumor with carinal reconstruction in a 4-year-old boy

Inflammatory myofibroblastic tumor of the carina and the main bronchus is a rare tumor. The authors report here on a case of a 4-year-old boy with an inflammatory myofibroblastic tumor at the carina and extending to the left main bronchus. He presented with fever and a cough of 2 months' duration. Preoperative assessment of the tumor revealed an intraluminal round mass arising from the carina and extending into the left main bronchus, and this caused near-total obstruction of the left main bronchus and the subsequent total collapse of the entire left lung. The complete resection of the mass with carinal reconstruction was successful. The tumor was a round mass measuring 1.5 × 1 cm. It had characteristic features of an inflammatory myofibroblastic tumor, namely, the proliferation of spindle-shaped fibroblasts and myofibroblasts.     

Is calcifying fibrous pseudotumor a late sclerosing stage of inflammatory myofibroblastic tumor?

Calcifying fibrous pseudotumor is a recently described distinctive lesion, characterized by the presence of abundant hyalinized collagen with psammomatous or dystrophic calcifications and a lymphoplasmacytic infiltrate. The cause and pathogenesis are unclear, but a possible relationship with other pseudotumors, like nodular fasciitis or inflammatory myofibroblastic tumor, has been proposed by some authors. However, cases with overlapping histologic features have not been reported. A 17-year-old girl with multiple peritoneal calcifying fibrous pseudotumors and inflammatory myofibroblastic tumors (inflammatory pseudotumors) is described. Some multinodular lesions showed calcifying fibrous pseudotumors next to inflammatory myofibroblastic tumors. Transitional stages between calcifying fibrous pseudotumor and inflammatory myofibroblastic tumor were also present. This case clearly illustrates a histogenetic relationship between calcifying fibrous pseudotumor and inflammatory myofibroblastic tumor, and it suggests that calcifying fibrous pseudotumor is a late sclerosing stage of inflammatory myofibroblastic tumor, at least in some cases.     

Inflammatory myofibroblastic tumor of renal pelvis presenting with prolonged fever and abdominal pain in children: report of 1 case and review of literature

Inflammatory myofibroblastic tumor is a reactive proliferative lesion that occurs extremely rarely in the renal pelvis, especially during childhood. We report 1 such case that occurred in a child who presented with prolonged fever and abdominal pain. Ultrasonography and abdominal computed tomography revealed a left renal pelvic mass. She received conservative surgical treatment. The diagnosis was confirmed by pathological and immunohistochemical studies. Distinguishing inflammatory myofibroblastic tumor from other malignant renal pelvic tumors in children is essential to preventing unnecessary nephrectomy.     

Inflammatory myofibroblastic tumor presenting with esophageal obstruction and an inflammatory syndrome

Inflammatory myofibroblastic tumor is a rare neoplasm of intermediate malignant potential. Although inflammatory myofibroblastic tumor occurs at multiple anatomic locations, an esophageal lesion is extremely rare. We describe a 43-year-old man who presented with severe dysphagia and an inflammatory syndrome, secondary to esophageal inflammatory myofibroblastic tumor. The patient was treated successfully with esophagectomy and remains disease free at 1 year. This case illustrates the complexities involved in managing a large esophageal myofibroblastic tumor and highlights that esophagectomy, rather than enucleation, should be the treatment of choice.     

Inflammatory myofibroblastic tumor of the larynx

BACKGROUND: Inflammatory myofibroblastic tumor, composed of myofibroblastic spindle cells with acute and chronic inflammatory cells, is an unusual, benign solid mass that mimics a neoplastic process. METHODS: We report a rare case of a patient with a laryngeal inflammatory myofibroblastic tumor. Laryngoscopy demonstrated a submucosal mass involving the right false cord. The mass was a well-enhanced supraglottic lesion on CT scan. It showed medially high signal intensity and peripherally low signal intensity on T2-weighted MR images, and it displayed a high magnetization transfer ratio; before surgery, it was believed to be a malignant tumor. Laryngoscopic biopsy was performed. Pathologic features of the specimen were diagnostic for inflammatory myofibroblastic tumor. RESULTS: Steroid therapy was chosen for further treatment. No recurrence was observed for 4 years. CONCLUSION: In patients with chronic hoarseness who have a malignant-looking submucosal laryngeal mass, inflammatory myofibroblastic tumor should be considered. Conservative surgery and steroid treatment are advocated because of laryngeal preservation.     

A case of inflammatory myofibroblastic tumor of the bladder

Here we report a rare case of inflammatory myofibroblastic tumor of the bladder. The patient was a 72-year-old man. We diagnosed this case preoperatively as urachal tumor from urine cytology, cystoscopy, and magnetic resonance imaging. We performed partial cystectomy. Histopathological examination revealed that the tumor was an inflammatory myofibroblastic tumor. To our knowledge, this is the 51st reported case of inflammatory myofibroblastic tumor of the bladder in Japan. He has been followed up for 13 months without any evidence of local recurrence.     

Inflammatory myofibroblastic tumor of the lung- a case report

A 45-year-old man presented with a six-month history of progressive dyspnea with productive cough and wheezing. The patient was a heavy smoker and had a history of tongue cancer, hypertension, and asthma. Chest X-ray and computed tomography showed a mass lesion in the left hilar region and total collapse of the upper left lobe of the lung. Bronchoscopy revealed a whitish solid tumor obstructing the left upper lobe bronchus. Positron emission tomography showed increased tracer uptake in the lesion. A thoracoscopic lobectomy of the left upper lobe of the lung was performed. The final pathologic diagnosis was inflammatory myofibroblastic tumor.     

Inflammatory myofibroblastic tumor of the ulnar nerve. Case report and review of the literature

Inflammatory myofibroblastic tumors with involvement of cranial and peripheral nerves are exceedingly rare. The authors present the case of a 67-year-old man with an inflammatory myofibroblastic tumor of the left ulnar nerve, which was identified intraoperatively and mimicked a malignant neoplastic lesion. Histopathological examination revealed loosely structured fibrous tissue and collagen deposits intermingled with patchy infiltrates of lymphocytes, plasma cells, and histiocytes penetrating the endo- and epineurium of the affected nerve fascicles. There was strong expression of vimentin and actin in spindle cells throughout the lesion. The histiocytes were CD68- and major histocompatibility complex class II-positive, but lacked CD1a expression. A review of the literature revealed nine histopathologically confirmed cases of inflammatory myofibroblastic tumors involving peripheral or cranial nerves in which slight differences in histopathological features and surgical management were found, which are discussed here.     

Inflammatory myofibroblastic tumors of the kidney: a clinicopathologic and immunohistochemical study of 12 cases

Inflammatory myofibroblastic tumor is a rare entity composed of spindle cells admixed with variable amounts of extracellular collagen, lymphocytes, and plasma cells. In the genitourinary tract, inflammatory myofibroblastic tumor most commonly occurs in the bladder. Isolated case studies of inflammatory myofibroblastic tumor of the kidney, renal pelvis, and ureter have been previously reported. Our series includes 12 cases of inflammatory myofibroblastic tumor occurring in the renal pelvis (six cases), renal parenchyma (four cases), and immediate perirenal soft tissue (two cases). Clinical presentation included flank pain (two patients), painless gross hematuria (one patient), and ureteropelvic junction stenosis with hydronephrosis (one patient). The remaining eight patients were asymptomatic. All patients underwent nephrectomy. The tumors were characterized by firm white tissue or had a myxoid "gelatinous" appearance. Three histologic patterns were identified in the tumors, including a myxoid vascular pattern, a compact spindle cell pattern, and a hypocellular fibrous pattern. Immunohistochemical and electron microscopic studies supported a myofibroblastic proliferation. All cases were negative for anaplastic lymphoma kinase. Follow-up was available in eight cases and ranged from 1 to 17 years with no evidence of recurrence. Based on this series, renal inflammatory myofibroblastic tumor is a proliferative lesion of myofibroblasts of uncertain pathogenesis with no identified potential for recurrence or metastases.     

Inflammatory myofibroblastic tumor of the left lower lobe invading the upper lobe ahead of fissure

We described a case of pulmonary inflammatory myofibroblastic tumor that was resected video-assisted thoracoscopic surgery (VATS) with safety surgical margin. The legion masqueraded primary lung cancer showing invasion to neighboring lobe. Positron emission tomography (PET) was not helpful in diagnosing whether it was malignant or not. Inflammatory myofibroblastic tumor was called as inflammatory pseudotumor, formerly. Several reports, however, suggested that so called inflammatory pseudotumor was a true neoplasm rather than a proliferating tissue due to inflammatory response. It is not rare that inflammatory myofibroblastic tumor invades neighboring organ or shows relapsing after coarse margin resection. Our case would remind pulmonary physicians of its correct treatment, i.e. surgical resection with adequate safety margin.     

Inflammatory myofibroblastic tumor of the left ventricle in an older adult

We report an unusual study of a 72-year-old woman who presented with a symptomatic space-occupying lesion in the left ventricle. The lesion was surgically excised with a good long-term result. It was histologicaly diagnosed as an inflammatory myofibroblastic tumor. Also known as an inflammatory pseudotumor, these tumors affecting the heart are extremely rare and occur mainly in children and adolescents. We review the literature and highlight the unique nature of the lesion.     

Inflammatory Myofibroblastic Tumor of the Ileocecal Mesentery Mimicking Abdominal Lymphoma in Childhood: Report of Two Cases

An inflammatory myofibroblastic tumor is an uncommon benign tumor located in various organs that can be misdiagnosed as a malignant neoplasm. We herein present two patients with ileocecal inflammatory myofibroblastic tumors. An abdominal mass was detected in a 13-year-old girl and a 15-year-old boy who presented with paleness, fatigue, intermittent fever, and night sweating. The radiological findings confirmed a mass originating from the ileocecal region. The presumptive diagnosis was Burkitt’s lymphoma. The histopathological diagnosis was inflammatory myofibroblastic tumor. After a surgical resection, all systemic symptoms rapidly resolved. Inflammatory myofibroblastic tumor is a rare pseudosarcomatous clinical and pathological entity. Although this tumor is more commonly reported in the lung, it can be detected in extrapulmonary sites, including the mesentery. Because the choice of treatment for this tumor is conservative surgery, an accurate preoperative analysis is important to avoid any unnecessary aggressive surgical intervention or other therapeutic approaches.     

直肠及肛周炎性肌纤维母细胞瘤三例

目的 探讨直肠及肛周炎性肌纤维母细胞瘤的临床特点及其疗效.方法 回顾性分析2005年1月至2011年6月术后病理证实为直肠或肛周炎性肌纤维母细胞瘤3例患者的临床资料.结果 炎性肌纤维母细胞瘤局部表现为浸润性生长,MRI或CT常表现为富血管实性肿块,影像学难以同直肠癌或肉瘤、血管瘤鉴别,术前肠镜活检或局部针吸活检常难以明确肿瘤性质,需手术切除后整体送检,并行免疫组化确诊.3例患者均行保肛手术,1例患者术后16个月出现复发,再次行根治性手术,随访至今.3例患者已分别存活67、55和35个月.结论 直肠及肛周炎性肌纤维母细胞瘤术前不易确诊,病理诊断主要依赖免疫组化.局部完整切除可以在保留肛门的同时获得肿瘤的根治,局部复发也常有再次手术机会.     

Inflammatory myofibroblastic tumor of the trachea; report of a case

A 45-year-old female with a complaint of dyspnea was admitted to our hospital. Computed tomography (CT) and bronchoscopy revealed a 10 mm intraluminal polypoid tumor with a smooth surface and hemorrhagic tendency located in the tracheal wall 2.0 cm distal from the vocal cords. For pathological diagnosis, airway management and hemorrhage control, tumor resection was performed using a rigid bronchoscope and neodymium yttrium aluminum garnet (Nd-YAG) laser under general anesthesia. Histologically, the tumor was diagnosed as an inflammatory myofibroblastic tumor of the trachea. Inflammatory myofibroblastic tumor is typically a benign tumor that develops in such sites as the lung, stomach, and mesentery. To the best of our knowledge, this is the first reported case of an inflammatory myofibroblastic tumor arising in the trachea.     

Myofibroblastic tumor causing severe neonatal distress. Successful surgical resection after embolization

This report describes a case of a term male 3.1 kg, normal delivery, 38 weeks of gestation with a record of hydramnios by prenatal sonography. He had fetal acute suffering and respiratory distress. The first radiographic study showed a mass filling the whole left thorax cage causing erosion of the inferior edge of the third rib. The mediastinum was displaced to the right. Computed tomography scan confirmed a homogeneous tumor that filled the left thorax and displaced the mediastinum to the right without invasion. Surgical biopsy informed of a highly vascularized mesenchymal tumor. The tumor was embolized with Ivalon microparticles obtaining a nearly avascular mass. Complete surgical excision was made, including the whole mass and costal segments. Microscopically, it was an inflammatory myofibroblastic tumor. It was composed mainly of spindle-shaped cells without malignant features. On immunohistochemistry, the tumor showed positive staining for vimentin, whereas antidesmin antibodies and S-100 protein were negative. The aim of this article is to present an extremely uncommon case of neonatal distress caused by an intrathoracic, extrapulmonary myofibroblastic tumor. Complete surgical resection was possible after embolization.     

Multiple cardiac inflammatory myofibroblastic tumors in the right ventricle in an infant

Reported is the successful treatment of a 2-month-old boy with multiple inflammatory myofibroblastic tumors in the right ventricle protruding into the right atrium through the tricuspid annulus. The patient underwent subtotal excision on cardiopulmonary bypass with no intraoperative or postoperative complications. Cardiac inflammatory myofibroblastic tumors are rare lesions, and surgical resections in patients as young as 2 months have not been previously described. In this report we review the relevant literature and discuss the prevalence, histology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, and treatment of cardiac inflammatory myofibroblastic tumor.     

Inflammatory myofibroblastic tumor involving liver,gallbladder, pylorus & duodenum: A rare case presentation

Inflammatory myofibroblastic tumors are rare benign tumors that can mimic malignancy of unknown aetiology. It has spectrum of myofibroblastic proliferation along with varying amount of inflammatory infiltrate. Recently, the concept of this lesion being reactive has been challenged based on the clinical demonstration of recurrences and metastasis and cytogenetic evidence of acquired clonal chromosomal abnormalities. We hereby report a case of inflammatory myofibroblastic tumor involving liver, gallbladder pylorus and 1st part of duodenum.