Inflammatory Myofibroblastic Tumours of the Urinary Bladder: Multi-Centre 18-Year Experience

Abstract

Objective: To review a series of inflammatory myofibroblastic tumours (IMTs) of the urinary bladder in 10 hospitals in Hong Kong. Methods: A database search in the pathology archives of 10 hospitals in Hong Kong from 1995 to 2013 was performed using the key words ‘inflammatory myofibroblastic tumour', ‘inflammatory pseudotumour' and ‘spindle cell lesion'. Patient characteristics, clinical features, histological features, immunohistochemical staining results and treatment outcomes were reviewed. Results: Nine cases of IMT of the urinary bladder were retrieved. The mean age was 45.4 ± 22.8 years (range 11-78). Eight patients (88.9%) presented with haematuria and 5 patients (55.6%) had anaemia with a mean haemoglobin level of 6.8 ± 1.3 g/dl. Histologically, the majority of patients (77.8%) had a compact spindle cell pattern. Anaplastic lymphoma kinase staining was positive in 75% of cases. During a mean follow-up period of 43.4 months (range 8-94), none of them developed any local recurrence or distant metastasis. Conclusions: A high index of suspicion of IMT should be maintained for young patients presenting with bleeding bladder tumours and significant anaemia. IMTs of the urinary bladder run a benign disease course, and good prognosis can be achieved after surgical resection.

Multi-centers clinicopathological prognosis study of inflammatory myofibroblastic tumors of urogenital system in China

“…The median age of kidney IMTs 39 years (range 6-74 years) in our study doesn't consist with the mean age 57.1 years in a large study [9] , but consists with the mean age 43.3 years of literatures review in the 13 case reports. In addition, it agrees with other reports that the age of onset, concentrated in 25-72 years (median 51.5 years), and the most common symptom is hematuria with more than half of them being anemia upon presentation of bladder IMTs in our study [6,8,17] . Sarcomatoid urothelial carcinoma et al are the most significant subtypes in the differential diagnosis of IMTs.…”

“…IMTs, a rare subtype with unique clinical and pathologic characteristics, in which the dominant components is spindle cells, and other components including alterable extracellular collagen, lymphocytes, and plasma cells [9] . IMTs, originally reported in the lung, has been recognized at multiple extrapulmonary sites, particularly the soft tissue and solid organs of children and young adults [1,3,8] . The the most common site of IMTs of genitourinary system is the urinary bladder.…”

“…In addition, steroids, nonsteroidal antiinflammatory drugs (NSAIDs), chemotherapy, and radiotherapy have been used as adjuvant therapy if necessary [5] . Up to now, there are only several studies [3,[6][7][8] of urinary system IMTs relied on enormous population. Unfortunately, these studies described mainly the clinicopathological characteristics so that all of them maybe not illustrate the incidence, survival, mortality and prognosis of urinary system IMTs.…”

Inflammatory myofibroblastic bladder tumor with divergent behavior in a patient with spinal cord injury

“…SCC of the bladder may occur in patients with either long‐term indwelling catheters, schistosomiasis, chronic irritation due to vesical calculus, or chronic cystitis . Some SCCs develop sarcomatoid changes and sometimes exhibit myxoid features that mimic IMT . The present case describes a SCC bladder tumor with sarcomatoid changes in the bladder diverticulum, in which initial pathology was shown as an IMT.…”

“…An IMT should be treated carefully because the most important entity in the differential diagnosis is urothelial carcinoma with sarcomatoid changes . Urothelial carcinomas occasionally develop sarcomatoid changes.…”