ALK-negative urachal inflammatory myofibroblastic tumor in an elderly female

Abstract

Rationale:Inflammatory myofibroblastic tumor (IMT) is a rare soft tissue lesion, originally reported in the lungs. Occurrence of the IMT was also documented in the digestive system, but rare in the urinary system, especially in the urachus, and little is presently known about IMT.Patient concerns:This study reported a very rare case of urachal IMT in an elderly female patient at the age of 77 who was diagnosed with a lower abdominal mass 2 months ago.Diagnosis:The preoperative diagnosis was urachal carcinoma, which was confirmed to be anaplastic lymphoma kinase (ALK) negative urachal IMT by postoperative histopathology and immunohistochemistry tests.Interventions:Laparoscopic radical urachal carcinoma resection and partial bladder resection was performed under general anesthesia, and the tumor was completely removed.Outcomes:There was no recurrence and metastasis over 22 months of follow-up.Lessons:The urachal IMT occurs mainly in males and nonelderly people with ALK positive while in females with ALK negative. The most common clinical manifestations of urachal IMT are lower abdominal masses; it is very important to distinguish whether the tumor originates from the bladder or the urachus, because the surgical treatment options are completely different. Currently the complete surgical removal of the tumor is the best treatment option for urachal IMT. No other adjuvant therapy is required after operation. All urachal IMT after follow-up showed no recurrence and metastasis, suggesting a good prognosis. However, IMT has malignant potential and it requires a long-term close follow-up check.

A rare case of urachal inflammatory myofibroblastic tumor

“…To our knowledge, only 8 cases of IMT have been described in the literature. 4 The age range of these cases was 3 years–77 years, with 4 cases presenting before age 18, and 6 cases noted in males. Typical presenting symptoms include abdominal and/or pelvic pain and sometimes lower urinary tract symptoms including dysuria or hematuria.…”

Inflammatory Myofibroblastic Tumor of the Urinary Bladder: An 11-Year Retrospective Study From a Single Center

“…Histopathologically, tumors can present with one type or a combination of two or Abbreviations: IMTUB, inflammatory myofibroblastic tumor of the urinary bladder; TURBT, transurethral resection of bladder tumor; PC, partial cystectomy; RC, radical cystectomy; ALK, anaplastic lymphoma kinase; IMT, inflammatory myofibroblastic tumor; SMA, smooth muscle actin; CK, cytokeratin; CT, computed tomography; NEUT%, neutrophil ratio; PCT, procalcitonin; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; EBV, Epstein-Barr virus. three types (7,8). In addition to the three histopathological types, other histopathological characteristics (such as the presence of necrosis, atypia, pleomorphism, abnormal mitosis, and mitotic figures) and a large number of inflammatory cells (such as lymphocytes, plasma cells, neutrophils, and eosinophils) were recorded.…”

“…Histopathologically, IMTs can be categorized into three histopathological subtypes based on pathological morphology: the mucous/vascular type, the compact spindle cell type, and the hypocellular fibrous type ( 5 , 7 , 8 ). The mucous/vascular type features fasciitis, edema, or loose arrangement of plump cells in a mucinous stroma with prominent vessels.…”

“…The hypocellular fibrous type is similar to the fibromatosis type, but with vimineous rather than full spindle cells on a background of dense collagenous stroma, including sporadic plasma cells, eosinophils, and lymphocytes. Histopathologically, tumors can present with one type or a combination of two or three types ( 7 , 8 ). In addition to the three histopathological types, other histopathological characteristics (such as the presence of necrosis, atypia, pleomorphism, abnormal mitosis, and mitotic figures) and a large number of inflammatory cells (such as lymphocytes, plasma cells, neutrophils, and eosinophils) were recorded.…”

ALK-negative urachal inflammatory myofibroblastic tumor in an elderly female: A case report: Erratum

“…In the article, “ALK-negative urachal inflammatory myofibroblastic tumor in an elderly female: A case report”, [1] which appears in Volume 97, Issue 51 of Medicine , the corresponding author information should appear as:…”