Imaging findings of inflammatory myofibroblastic tumor in breast

Abstract

Rationale:Inflammatory myofibroblastic tumors (IMTs), particularly breast IMTs, are rare neoplastic lesions typically associated with a favorable prognosis. Breast IMTs are easily misdiagnosed as other types of malignant lesions, and therefore there is a significant unmet need for a better preoperational differential diagnosis based on imaging manifestations. Here, we report the imaging findings of a breast IMT and compare our findings with previously published features of breast IMTs.Patient concerns:The patient, a 43-year-old female, reported the presence of a palpable lump within her left breast. An ultrasound examination revealed an irregular hypoechoic mass with unclear boundaries. Mammography demonstrated a mass of heterogeneous and striped density with granular calcification. Magnetic resonance image (MRI) inspection displayed an irregular tissue lump with an undistinguishable boundary and a further dynamic contrast-enhanced MRI disclosed an associated efflux change.Diagnoses:Breast inflammatory myofibroblastic tumors.Interventions:Breast needle biopsy and mammary resection were performed. Pathological staining of the bulk resected tumor after preoperative preparation revealed that the tumor-like tissue was enriched for spindle cells arranged in fascicular clusters. Histopathological diagnosis and immunohistochemistry confirmed the mass as being a breast IMT.Outcomes:No metastatic recurrence was found during 6-month or 1-year follow-ups.Lessons:Breast IMTs commonly develop in elderly women with atypical imaging features. They are primarily composed of lobular soft tissues infiltrated with an abundant focal blood supply and granular calcification. Development of breast IMTs is closely related to trauma. A preliminary diagnosis of such masses can be made based on combined manifestations of both clinical and imaging features, while a final confirmation still requires pathological staining. Imaging examinations are of value for such tumors to define the lesion edges and their associations with adjacent tissues.

Ultrasonic Manifestations of Mesenteric Inflammatory Myofibroblastic Tumors in Children

“…In the present study, we analyzed the sonograms of seven patients with mesenteric IMTs combined with their medical history, trying to figure out whether ultrasound could be used as a complement for CT in the preoperative diagnosis and long-term follow-up studies of pediatric IMT of the mesentery. We found that the ultrasound examination of the lower right abdomen showed an irregular hypoechoic mass that was partially lobulated, with uneven internal echo ( 12 ). Besides, the masses showed enhanced echoes in the surrounding intestine and omentum, and enriched internal blood flow signals ( Figures 1 , 2 ).…”

“…Ultrasound has a strong advantage in observing the activities of the tumors ( 11 ). However, previous reports on the ultrasound of pediatric abdominal IMT mostly focused on individual cases ( 12 ).…”

Inflammatory Myofibroblastoma of the Breast: A Case Report

“…We present a rare case of inflammatory myofibroblastoma that may be associated with trauma of the breast, similar cases have been reported where the lesion occurred near the postoperative site of fibroadenoma in the literature (21), which may provide some instruction for future clinical work: if a patient with a history of surgery has lesions in the surgical site, inflammatory myofibroblastic tumor may be included in the diagnosis. The patient was followed for 44 months without recurrence or metastasis.…”

Inflammatory myofibroblastic tumor after breast prosthesis: A case report and literature review

“…Vecchio et al [ 5 ] reported a male patient with breast IMT that had developed 4 mo following mechanical trauma; its location was consistent with the site of the trauma. Mao et al [ 2 ] reported a 43-year-old female who developed IMT 18 mo following resection of a left breast fibroadenoma. Both studies of Vecchio et al [ 5 ] and Mao et al [ 2 ] speculated that trauma and surgery could be important factors that promote the development of IMT.…”

“…They primarily occur in the lungs, abdomen, pelvis, and retroperitoneum of adolescents. Unlike IMTs in other organs, most breast IMTs occur in middle-aged women > 40 years old[ 2 ]. Although reported in various organs, the occurrence of IMT in the breast is rare, and to the best of our knowledge, only 35 cases have been reported.…”