Inflammatory Myofibroblastic Tumor in the Adrenal Gland: A Case Report

Abstract

Inflammatory myofibroblastic tumors (IMTs) were first described by Harold Brunn in 1939. IMTs are mainly found in the lungs and other sites of the body; hence, its occurrence in the adrenal gland is exceptional. In the literature, less than 10 cases of IMTs in the adrenal gland have been reported. The etiology of IMT remains unknown, with post-inflammatory changes and a neoplastic origin being proposed. We present a case of a 19-year-old woman and adrenal gland IMT. The patient presented with abdominal pain and low cardiac output without hypovolemic shock. Computed tomography revealed a tumor in the adrenal gland measuring 11.4 cm with extravasation of contrast medium within the tumor. Treatment included conservative management with selective embolization due to minimal invasion of the inferior artery of the adrenal gland. The patient was then discharged with possibility of future elective surgery. Four months later, the size of the tumor decreased to 6.3 cm, and her Eastern Cooperative Oncology Group physical status was 0. The Multidisciplinary Tumor Board suggested surgical management. The final histopathology report was compatible with an IMT of the adrenal gland, with the immunohistochemical report showing positivity for anti-actin muscle-specific and anti-actin smooth muscle and negativity for anaplastic lymphoma kinase. IMTs of the adrenal gland may be treated electively through multidisciplinary management together with interventional radiology and surgery, achieving a favorable outcome for the patient.