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

Abstract

PurposeTo share our experience in the diagnosis and treatment of an inflammatory myofibroblastic tumor of the urinary bladder (IMTUB).Materials and MethodsA database searches in the pathology archives by using the term “inflammatory myofibroblastic tumor” and” bladder” in our hospital department of pathology from 2010 to 2021. Patient characteristics, clinical features, histopathological results, immunohistochemical staining results, and treatment outcomes were reviewed.ResultsFourteen cases of IMTUB were retrieved. The mean age was 44.7 ± 18.9 years (range 12–74). Nine (64.3%) of the patients presented with hematuria, followed by seven (50%) with odynuria, five (35.7%) with urgent urination, and one (7.1%) with dysuria. Ten (71.4%) of the patients were treated with partial cystectomy (PC), three (21.4%) with transurethral resection of bladder tumor (TURBT), and one (7.1%) with radical cystectomy (RC). Histopathologically, eight (57.1%) had a compact spindle cell pattern. Anaplastic lymphoma kinase (ALK) staining was positive in six (75%) of 8 cases. During a mean follow-up period of 43.9 ± 38 months (range 3–117), a patient had recurrence within half a month. Then, the patient was treated with further TURBT surgery and had no recurrence within 6 months. Thirteen of the patients had no local recurrence or distant metastasis.ConclusionInflammatory myofibroblastic tumor of the urinary bladder (IMTUB) is clinically rare and has a good prognosis. The disease is mainly treated with surgery to remove the tumor completely. It can easily be misdiagnosed as bladder urothelial carcinoma, leiomyosarcoma, or rhabdomyosarcoma, which may result in overtreatment and poor quality of life of patients.

Inflammatory myofibroblastic tumor of the urinary bladder: A systematic review of the literature and report of a case

“…We compared the results of published case reports to collate the existing evidence derived from retrospective cohorts and case series. [ 24 25 26 27 28 29 30 31 32 ] Despite that, the literature remains scarce regarding the optimal diagnosis, management, and follow-up protocol for IMTs of the bladder. The largest systematic review on the topic included 182 patients, but included both the IMTs and pseudosarcomatous myofibroblastic proliferation of the bladder.…”

“…In cohort studies and case series,[ 24 25 26 27 28 29 30 31 32 ] the age of the patients diagnosed with bladder IMTs ranged between 3 and 89 years (mean age of 44 years), and the most common clinical presentation was gross hematuria, in more than 60% of the cases. While the pathological type was variable, the most common type of bladder IMT was the spindle cell pattern [ Table 1 ].…”

“…The role of abdominal and pelvic CT scans in the diagnosis of bladder IMTs is crucial in guiding the management, considering that the tumor size may reach more than 10 cm in diameter, as reported in our review and the previous studies. [ 24 25 26 27 28 29 30 31 32 ] This may help to assess the feasibility of complete resection of the tumor. Usually, these tumors have a cauliflower like appearance with a wide base on the CT scan, and most of the time they are endophytic.…”

Difficulties in diagnosing a myofibroblastic lung tumor in a child

“…ВМО состоит из дифференцированных миофибробластных веретенообразных клеток с многочисленными плазматическими клетками и/или инфильтратами лимфоцитов [2,5]. [1,7].…”