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Retroperitoneal inflammatory myofibroblastic tumor

DOI: 10.1186/1477-7819-3-66

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Abstract:

The present case is of a 46 years old woman presented with a history of flank pain, abdominal mass and intermittent hematuria for last 6 months. The initial diagnosis was kept as renal cell carcinoma. Finally, it turned out to be a case of retroperitoneal IMT. The patient was managed by complete surgical resection of the tumor.IMT is a rare neoplasm of uncertain biological potential. Complete surgical resection remains the mainstay of the treatment.Inflammatory myofibroblastic tumor (IMT) is a relatively rare neoplasm. The outlook of this disease has changed with time from a benign reactive process to a malignant neoplasm, based on the multiple case reports demonstrating recurrent and constant clonal genetic alterations [1-5]. There are three main histological patterns: nodular fasciitis-like, fibrous histiocytoma-like, and desmoid or scar tissue-type. Though morphologically similar, they encompass a spectrum of entities with varied etiology, ranging from reactive/regenerative proliferations to low-grade neoplasms with a risk of local recurrence, and metastatic potential [3]. The commonest site of IMT is lung with a few case reports from extra pulmonary sites [6]. In the genitourinary tract, it most commonly occurs in the bladder. However it rarely originates in the kidney, renal pelvis, and ureter [4]. In the English literature only six cases of retroperitoneal IMT were reported [6-8]A 46-years-old woman presented with history of flank pain, abdominal lump and intermittent hematuria of 6 months duration. She was diagnosed as renal cell carcinoma (RCC) elsewhere and referred. The investigations at our hospital revealed normal hematological and biochemical parameters. The urine microscopy showed deformed RBC. The computerized tomography (CT) scan of the abdomen showed a large irregular well defined heterogeneous lesion occupying the left hypochondrium, lumbar and supra umbilical regions, measuring approximately 16 × 13.6 × 12.1 cm, and showed presence of predominant

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