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Inflammatory myofibroblastic tumour of maxilla  [cached]
Deshingkar S,Tupkari J,Barpande S
Journal of Oral and Maxillofacial Pathology , 2007,
Abstract: Inflammatory myofibroblastic tumour (IMT) is a biologically controversial entity that was originally described as non-neoplastic lesion in the lungs and designated initially as inflammatory pseudotumour. The lesion has recently been recognized to occur at various sites but rarely affects head and neck region. Controversies still exist regarding its reactive versus neoplastic nature. The lesion has a potential for recurrence, persistent local growth, progression to frank sarcoma and metastasis. Hence IMT can best be regarded as a low-grade sarcoma. A case of a 30-year-old female with swelling in the right maxilla and associated ophthalmic manifestations is discussed here. Contribution of immunohistochemistry for diagnosis of IMT is emphasized. Additional cytogenetic studies of this highly enigmatic and minimally studied tumour are warranted.
Inflammatory myofibroblastic tumour of the gallbladder
Kasim A Behranwala, Peter Straker, Andrew Wan, Cyril Fisher, Jeremy N Thompson
World Journal of Surgical Oncology , 2005, DOI: 10.1186/1477-7819-3-24
Abstract: We report a case of a 51 year-old female, who had excision of a gallbladder tumour. Histopathology showed it to be IMT of the gallbladder.The approach to these tumours should be primarily surgical resection to obtain a definitive diagnosis and relieve symptoms. IMT has a potential for local infiltration, recurrence and persistent local growth.Inflammatory myofibroblastic tumour (IMT) is a rare benign lesion that has been discussed in various organs and tissues. They are well recognised in lung and upper respiratory tract of children and young adults with a predilection for first and second decade. Intra-abdominal forms of the disease are reported to occur most frequently in the liver, followed by stomach, bowel, spleen, mesentery [1] and extrahepatic bile duct [2]. The clinical presentation will vary on the site involved. We report a case of IMT of the gallbladder, which has not been previously described. A case of inflammatory pseudotumour of the gallbladder and bile ducts with synchronous lesion in the lung, has been described, which subsided on high-dose prednisolone therapy [3]. Another case of chronic cholecystitis with features of xanthogranulomatous inflammation due to the presence of a prominent inflammatory infiltrate composed of plasma cells, lymphocytes, macrophages, foamy histiocytes and huge fibroblastic and myofibroblastic proliferation was described by Corsi A et al [4].A 51-year-old female presented with history of acute right upper abdominal pain, localised abdominal signs and raised inflammatory markers. Ultrasound scanning suggested acute cholecystitis. The patient was explored initially by laparoscopy but converted to an open operation at the referring hospital. An irresectable mass, which was thought to be an advanced gallbladder carcinoma, was found. Several needle biopsies were taken from the tumour but the gallbladder was not excised. Histology of the biopsies showed features of IMT of the gallbladder. She developed obstructive jaundice posto
Intestinal inflammatory myofibroblastic tumour
S Ntloko, A Gounden, M Naidoo, TE MaDIBA, Y Sing, GP Hadley
South African Journal of Surgery , 2011,
Abstract: Background. Inflammatory myofibroblastic tumours (IMFTs) are rare tumours characterised by nosologic, histogenetic and aetiopathogenetic controversy and variable clinicopathological features. We report our experience with intestinal-IMFTs (I-IMFTs) that have been reported mainly as single case reports to date. Methods. Five patients with I-IMFTs, identified between 2005 and 2008, formed the study cohort. The clinicopathological features were obtained from departmental and hospital records. Results. The median patient age was 13 years. While 4 patients presented with symptoms and signs of intestinal obstruction, one IMFT was an incidental finding at laparotomy for trauma. Three I-IMFTs were located in the small bowel and 2 in the colon. Complete resection with end-to-end anastomoses was performed. The gross morphology included 1 polypoid myxoid tumour that served as a lead point for an intussusception, 3 multinodular whorled masses and 1 firm circumferential, infiltrative tumour.Microscopically, all tumours had typical features of IMFT with variable expression of ALK-1, a low proliferation index and tumour-free resection margins. All patients had an uneventful recovery. One patient was lost to further follow-up. Four patients were well, without local recurrence or metastases at 6 months to 3 years. Conclusions. Surgery with tumour-free resection margins is the gold standard of care of adult and paediatric I-IMFTs. Heightened recognition of I-IMFT, albeit rare, as a cause of intestinal obstruction, including intussusception, is necessary for preoperative suspicion of I-IMFT. SAJS, VOL 49, NO. 4, NOVEMBER 2011
Inflammatory Myofibroblastic Tumour of the Skull Base  [PDF]
Jean-Philippe Maire,Sandrine Eimer,Fran?ois San Galli,Valérie Franco-Vidal,Sigolène Galland-Girodet,Aymeri Huchet,Vincent Darrouzet
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/103646
Abstract: Inflammatory myofibroblastic tumors (IMTs) are rare benign clinical and pathological entities. IMTs have been described in the lungs, abdomen, retroperitoneum, and extremities but rarely in the head and neck region. A 38-year-old man presented with headache, right exophthalmia, and right 6th nerve palsy. A CT scan revealed enlargement of the right cavernous sinus and osteolytic lesions of the right sphenoid and clivus. MR imaging showed a large tumor of the skull base which was invading the sella turcica, right cavernous sinus, and sphenoidal sinus. A biopsy was performed and revealed an IMT. Corticosteroids were given for 3 months but were inefficient. In the framework of our pluridisciplinary consultation, fractionated conformal radiotherapy (FRT) was indicated at a low dose; 20?Gy in 10 fractions of 2?Gy over 12 days were delivered. Clinical response was complete 3 months after FRT. Radiological response was subtotal 6 months after FRT. Two years later, the patient is well. 1. Introduction Inflammatory myofibroblastic tumors (IMTs), also called inflammatory pseudo tumors or plasma cell granuloma, have been defined in the classification of soft tissue tumors as a lesion composed of myofibroblasts with inflammatory infiltrate [1]. This tumor is now recognized as a neoplastic mass that usually has an uneventful clinical course after radical resection. However, aggressive cases showing invasive, locally recurrent, multiple, and metastatic forms have also been reported [2]. This tumor has been primarily described in the soft tissues and viscera of children and young adults [3], with equal incidence in male and female patients [4]. IMT rarely affects the head and neck region. Despite an apparently benign morphological nature, they have been reported to have locally aggressive growth. Complete surgical excision has proved to be an effective treatment, with some recurrences occurring after surgery. Here, we report a rare case of a large IMT of the skull base causing headache, exophthalmia, and 6th nerve palsy, which could not be operated without heavy morbidity and which resolved after low-dose fractionated radiotherapy. 2. Case Report A 38-year-old man presented with headache, right exophthalmia, and right 6th nerve palsy. A CT scan revealed enlargement of the right cavernous sinus and osteolytic lesions of right sphenoid and clivus (Figure 1). MR imaging showed a large tumor of the skull base that was invading the sella turcica, right cavernous sinus, and sphenoidal sinus (Figure 1). A biopsy was performed and revealed a dense proliferation of spindle
Diagnostic challenge in Inflammatory Myofibroblastic Tumor: Case Report
T Tefera
East and Central African Journal of Surgery , 2012,
Abstract: Inflammatory myofibroblastic tumor (IMT) is a rarely described tumor of unknown etiology and pathogenesis. It occurs primarily in the lungs, but has occurred in other extra-pulmonary sites. Histologically these lesions appear as an inflammatory infiltrate within a variably myofibrotic background. Current evidence shows that inflammatory myofibroblastic tumors are neoplastic processes resulting from chromosomal translocations that often cause an overexpression of ALK kinase, which is often assessed using immunohistochemical studies. Currently, the biological behavior of oral inflammatory myofibroblastic tumor is still uncertain. This article describes the clinical, histological, and operative features of a case of IMT of the Mandible. I report such a case of inflammatory myofibroblastic tumor of the mandible in a 16-year-old girl. The patient presented with a large aggressive ulcerative soft tissue mass of 3 year duration in the rigth mandibular molar gingiva. Histologically, section show; loosely arranged myofibroblasts in an edematous and myxoid background with plasma cells, lymphocytes, eosinophils, and blood vessels and overlined by ulcerative skin, no necrosis or mitosis. Immunohistochemically, the fibroblastic or myofibroblastic spindle cells were positive for vimentin, á- smooth muscle actin, and Ki-67 (MIB-1) but negative for desmin, pan-cytokeratin, S-100 protein, CD34, CD68, CD99, bcl-2, a-catenin, estrogen receptor, progesterone receptor. These spindle cells were focally and weakly Ki-67- (MIB-1-) positive. A pathological diagnosis of inflammatory myofibroblastic tumor was made. The postoperative course was uneventful, and the patient has had no recurrence in the 1 year follow-up period. Although no evidence of oral inflammatory myofibroblastic tumor recurrence or malignant transformation has been reported, it has been observed that in inflammatory myofibroblastic tumors of other regions, a prolonged follow-up is necessary after surgical resection.
Retroperitoneal inflammatory myofibroblastic tumor
Suresh VS Attili, C Rama Chandra, Dadhich K Hemant, Poonamalle P Bapsy, Clementeena RamaRao, G Anupama
World Journal of Surgical Oncology , 2005, DOI: 10.1186/1477-7819-3-66
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
Inflammatory Myofibroblastic Tumor: A Rare Tumor in the Tongue  [PDF]
Nur Yucel Ekici,Tuba Bayindir,Ahmet Kizilay,Nasuhi Engin Aydin
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/787824
Abstract: Inflammatory myofibroblastic tumor is composed of myofibroblast and inflammatory cell infiltration of the tissue. Malign transformation and recurrence rate of this tumor is rare and accepted as benign fibroinflammatory disease. The main etiology is unclear, but infection, trauma, and immunologic event are accused. In this study, we presented a 75-year-old man with a mass on his tongue, which was diagnosed as “inflammatory myofibroblastic tumor.” This type of tumor is rarely seen in the tongue and might be difficult to diagnose. Complete mass excision was provided for an adaquete treatment. 1. Introduction Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor [1]. The etiology of IMT is contentious, also the nature of this tumor type (benign or malign) is still controversial [1–3]. But, because of its rarity, the current conception is altered from a benign reactive process to an intermediate neoplasm [4]. Different terms such as; inflammatory pseudotumor, histiocytoma, plasma cell histiocytoma complex, plasma cell granuloma, fibrohistiocytoma, xanthomatous granuloma, myxoid hamartoma, xanthomatous pseudotumor, spindle cell pseudotumor, inflammatory fibrosarcoma, benign myofibroblastoma, and inflammatory myofibroblastic proliferation were used for defining this tumor. World Health Organization (WHO) had consolidated this term as IMT in 1994 and declared it as a diagnostic classification for intermediate soft-tissue myofibroblastic neoplasm according to its well reproducible histological morphology [4, 5]. The tumor reported in the lung originally, but extra-pulmonary form, has been described in different organs and anatomic sites [6, 7]. Regardless of the site of origin, it is a circumscribed mass-forming process, composed of myofibroblasts, fibroblasts, histiocytes, and plasma cells. Although stromal fibrosis is a finding that is usually seen, tumor tends to be limited in the focal area [6, 8]. IMT is preferentially occurring in children and young adults [6]. In this report, we presented a 75-year-old male patient with inflammatory myofibroblastic tumor of the tongue presenting with pediculated large mass. 2. ??Case Report A 75-year-old man was referred to our clinic with a painless, pediculated large mass on the left side of the tongue. The lesion grew rapidly within four months. Oral examination revealed an approximately 4 centimeter (cm) in diameter, hard, partially ulcerated, and pediculated large mass on the left side of the tongue (Figure 1). There was no regional lymphadenopathy, and the remainder of physical examination was
Inflammatory Myofibroblastic Tumour of the Skull Base  [cached]
Jean-Philippe Maire,Sandrine Eimer,Fran?ois San Galli,Valérie Franco-Vidal
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/103646
Abstract:
Inflammatory myofibroblastic tumor of the larynx  [PDF]
Mijovi? ?aklina,Mihailovi? Dragan,Kostov Milo?
Vojnosanitetski Pregled , 2008, DOI: 10.2298/vsp0810779m
Abstract: Background/Aim. Inflammatory myofibroblastic tumor (IMT) of the larynx is a rare borderline lesion composed of myofibroblastic and inflammatory cells. Case report. We presented a case of 77-year-old male with hoarseness for about three months. Laryngoscopy showed a polypoid tumor originated from the anterior commissure with glottic projection. Grossly, the tumor was 22 × 15 mm, whitish, oval nodus with firm consistency. Histologically, the lesion was composed of spindled to stellate cells arranged in a fascicular to storiform pattern and inflammatory cells: lymphocytes, histiocytes, plasma cells and neutrophils. The stroma was fibromyxoid and collagenous. Immunohistochemically, tumor cells showed strong positivity for actin and vimentin and negativity for cytokeratin, CD34, S100 and desmin. The proliferation (Ki67) was less than 10%. Conclusion. Inflammatory myofibroblastic tumor may be mistaken as a malignancy and the differential diagnosis can be difficult without immunohistochemistry. It is critical to recognize this uncommon entity to avoid unnecessary aggressive treatment.
Inflammatory myofibroblastic tumor of the urinary bladder
Yagnik Vipul,Chadha Amit,Chaudhari Sanjay,Patel Keyuri
Urology Annals , 2010,
Abstract: Inflammatory myofibroblastic tumor (IMT) of bladder is an uncommon benign tumor of bladder, which is of unknown neoplastic potential, characterized by spindle cell proliferation with characteristic fibroinflammatory and pseudosarcomatous appearance. Essential criteria for the diagnosis of IMT are: spindle myoepithelial cell proliferation and lymphocytic infiltrate. Complete surgical resection is the treatment of choice.
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