Inflammatory myofibroblastic tumors of the breast with simultaneous intracranial, lung, and pancreas involvement: ultrasonographic findings and a review of the literature

Abstract

We encountered a case of inflammatory myofibroblastic tumor (IMT) of the breast with simultaneous intracranial, lung, and pancreas involvement. Here, we present the clinical imaging results and report the significance of sonographic findings of breast IMT along with a review of the literature. A 16-year-old girl with a history of subarachnoidal hemorrhage was admitted to our hospital due to tonic-clonic seizure. Computed tomography (CT) and magnetic resonance imaging (MRI) showed multiple intracranial, lung, and pancreas mass lesions and a solitary mass lesion in the right breast. Breast ultrasonography showed a circumscribed oval-shaped hypoechoic mass with a central hyperechoic region. Power Doppler sonography revealed an unusual spiral-shaped flow signal. Breast tumorectomy was performed for definitive diagnosis, and pathological analysis indicated IMT. A literature review indicated that ultrasonographic findings of IMT of the breast are nonspecific, as in other systems or organs. It would be difficult to make a diagnosis of IMT of the breast preoperatively due to its rarity and the lack of specificity of clinical imaging findings. In addition, it is better to consider the possibility of IMT of the breast especially in younger patients without an obvious family history of hereditary breast cancer.

Imaging findings of inflammatory myofibroblastic tumors in the breast: a case description and literature analysis

“…Previous studies have reported that rare disease occurs in people at all age stages with a major female preponderance, and the average age of onset is 44.6 years old (age range: 13–86 years) ( 13 , 14 ). There are no specificity in the clinical symptoms.…”

Clinicopathological Features of Inflammatory Myofibroblastic Tumor in the Breast

“…Up to now, 6 cases of breast IMT reported had recurrence and metastasis after the first operation, including recurrence of the primary site of tumor, recurrence of the bilateral breast [ 10 , 15 ], axillary lymph node metastasis [ 25 ], inguinal metastasis [ 2 ], and supraclavicular lymph node metastasis, and adjacent rib destruction was also reported [ 27 ]. Inoue et al [ 32 ] reported a case of IMT of the breast with simultaneous intracranial, lung, and pancreas involvement. In our case, 6 months after operation, ultrasound showed irregular hypoechoic areas in the local area, but only postoperative inflammation and reactive hyperplasia were found in the postoperative pathology, and no residual or recurrence of tumor was found.…”

Imaging features and radiologic-pathologic correlations of inflammatory pseudotumor-like follicular dendritic cell sarcoma

“…IPT-like FDCSs of the spleen displayed homogeneous or heterogeneous hypoechoic lesions, consistent with ultrasonographic findings in other studies [ 3 ]. The patchy hyperechoic area detected in the tumor was related to the infiltration of numerous inflammatory cells [ 13 , 14 ]. The abundant strip or short-rod blood flow signals in the periphery, and the circular enhancement around lesions in contrast-enhanced ultrasonography, were consistent with the blood vessel distribution in the pseudocapsule of the tumor in the pathological findings.…”