Follow-Up Imaging of Inflammatory Myofibroblastic Tumor of the Uterus and Its Spontaneous Regression

Vasiljkovic, Biljana Markovic; Karapandžić, Vesna Plešinac; Pejcic, T.; Stefanović, Aleksandra; Milošević, Zorica; Plešinac, Snežana

doi:10.5812/iranjradiol.12991

Cited by 14 publications

(15 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The "wait-and-see" approach was also described as a safe treatment of IMTs in adults as well as in pediatric cases (8,15,16). Data were also published about spontaneous regression of a hepatic IMT (8).…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Myofibroblastic Tumors in the Uterus: Childhood-Case Report and Review of the Literature

2020

View full text Add to dashboard Cite

Inflammatory myofibroblastic tumor (IMT) is a spindle cell neoplasm with low malignant potential, which may appear in different parts of the body. Uterine localization is rare, especially among children. Etiology is unclear, although some authors suggest underlying trauma or distress. A 3.5-year-old girl was treated at our institute for recurring vaginal bleeding without injury or known pathology. Physical examination and laboratory analysis revealed no specific findings, contrast-enhanced MRI found a 25 × 28 × 30 mm-sized inhomogeneous soft tissue mass in the uterus wall, which was excised in toto. Histological examination identified a spindle cell pattern, and the FISH test revealed ALK gene rearrangement, the lesion was defined as an IMT. Six cases were published to date, and their diagnostic methods are not equivocal, CT, and PET CT were preferred instead of MRI. Aggressive therapy seems to be exaggerated according to low recurrence and metastasis occurrence, and crizotinib is proved as good therapeutic agent in those cases. Biopsy and histology has important role in order to distinguish IMT from malignancies completed with FISH examination because ALK positivity strengthens the diagnosis. No lethal outcome was published among children, as our patient is also symptom-free after 3 years.

show abstract

Section: Discussionmentioning

confidence: 99%

Inflammatory Myofibroblastic Tumors in the Uterus: Childhood-Case Report and Review of the Literature

2020

View full text Add to dashboard Cite

show abstract

“…IMTs show spontaneous regression in a minor fraction of patients, although the actual incidence is unclear due to surgical interventions and asymptomatic/undetected cases. To date, 13 cases of spontaneously regressed IMTs have been reported in various organs, but not in the pancreas (Table 2) [27][28][29][30][31][32][33][34][35][36][37][38]. As mentioned above, reported cases of pancreatic pseudotumors or those without proven myofibroblastic tissues were not listed [15,23].…”

Section: Discussionmentioning

confidence: 99%

“…Anti-inflammatory agents, such as corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDS), are effective for some IMTs [27,28], and a small proportion of IMTs regress spontaneously [27][28][29][30][31][32][33][34][35][36][37][38]. To date, several cases of pancreatic IMTs have been reported , but histologically proven cases (proven for myofibroblastic component) with spontaneous remission have hardly been reported.…”

Section: Introductionmentioning

confidence: 99%

A Pancreatic Inflammatory Myofibroblastic Tumor with Spontaneous Remission: A Case Report with a Literature Review

et al. 2019

View full text Add to dashboard Cite

The inflammatory myofibroblastic tumor (IMT) is a rare tumor that can develop in any systemic organ. Its features are generally benign, but it often resembles malignancies and is treated surgically. Our patient was an 82-year-old female complaining of abdominal discomfort. Computed tomography demonstrated a 5 cm, ill-enhanced mass at the pancreas head. Upper gastrointestinal endoscopy revealed a duodenal submucosal tumor with apical erosion. Endoscopic ultrasonography (EUS) demonstrated a heterogeneous, low-echoic pancreas mass without clear margins. Fine-needle aspiration biopsy (FNAB) demonstrated spindle myofibroblastic tissues with lymphoplasmacyte and eosinophil infiltration, confirming an IMT diagnosis. Surprisingly, the tumor spontaneously regressed in one month without medication. Histological diagnosis using EUS-FNAB is essential for the rare pancreatic solid tumor like IMT.Medication had been initiated using nizatidine, rebamipide and oxetacaine, but it was not effective. She had a history of hypertension, but her family history was unremarkable. Blood tests showed modestly elevated IgG (1950 mg/dL, normal range: 870-1700 mg/dL) and C-reactive protein (0.43 mg/dL, normal range: ≤ 0.3 mg/dL) but normal readings for other factors, including serum tumor markers (carcinoembryonic antigen, carbohydrate antigen, and soluble IL-2 receptor), HbA1c, and IgG4 (66.1 mg/dL, normal: 4.5-117 mg/dL). Enhanced computed tomography (CT) demonstrated an ill-enhanced mass, 5 cm in size but with unclear margins, located at the pancreas head (Figure 1a,b). Upper gastrointestinal endoscopy revealed a submucosal tumor (SMT) with an apical erosion approximately 1.5 cm in size at the duodenal bulbs ( Figure 2). Several faintly enlarged lymph nodes were seen around the pancreas head, but no nodules suggestive of metastasis were visible in the liver or the lungs. Endoscopic ultrasonography (EUS) demonstrated a heterogeneous, low-echoic mass at the pancreas head and body, but no adhesion to the common bile duct. EUS elastography revealed a hardness of the pancreas lesion (Figure 3). Forceps biopsy (Radial Jaw™4, Boston Scientific Japan, 2.2 mm, Tokyo, Japan) from the duodenal SMT was not informative, but EUS-guided fine needle aspiration biopsy (FNAB) showed abundant spindle myofibroblast tissues with eosinophilic and lymphoplasmacytic cell infiltration (Figure 4). FNAB was performed with two punctures from the duodenal bulbs, with each puncture performed with 10 strokes using a 22-gauge Franseen-tip needle (Acquire™, Boston Scientific Japan) with 10 mL of negative pressure. No malignant cells were seen. The spindle cells were positive for anti-smooth muscle antibody (ASMA) and desmin but negative for discovered on GIST-1 (DOG-1), c-Kit, CD34, S-100, and ALK. Only six IgG4-positive cells were recognized in high-powered views, and no obliterative phlebitis or storiform fibrosis was detected. These findings led to the diagnosis of IMT.

show abstract

“…Mitotic index was observed to be higher in cases with recurrence or metastases [4]. A case of IMT with complete regression over a course of two years was reported, the tumor showed a regression from periphery towards uterus, in a manner called "rewind backwards" when given a short course of antibiotics [20].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory myofibroblastic tumor of the uterus that might STUMP you: Report of a case with clinicopathological and immunohistochemical findings

Tawfik¹,

Arshi²,

Algren³

et al. 2018

J Mod Hum Pathol.

View full text Add to dashboard Cite

Inflammatory myofibroblastic tumor is an under-recognized locally aggressive tumor that has rarely been described in the uterus. We present a case in a 40-year-old patient with a large tumor mass in the posterior wall of her uterus. The patient was followed for years clinically and assumed to have a leiomyomatous lesion. The clinical, histopathological and immunohistochemical features are discussed with review of the literature.

show abstract

Follow-Up Imaging of Inflammatory Myofibroblastic Tumor of the Uterus and Its Spontaneous Regression

Cited by 14 publications

References 13 publications

Inflammatory Myofibroblastic Tumors in the Uterus: Childhood-Case Report and Review of the Literature

Inflammatory Myofibroblastic Tumors in the Uterus: Childhood-Case Report and Review of the Literature

A Pancreatic Inflammatory Myofibroblastic Tumor with Spontaneous Remission: A Case Report with a Literature Review

Inflammatory myofibroblastic tumor of the uterus that might STUMP you: Report of a case with clinicopathological and immunohistochemical findings

Contact Info

Product

Resources

About