Abstract:IPTs may be definitively diagnosed only by histopathological examination and are most effectively treated by resection with negative surgical borders. No consensus has yet been reached regarding when nonsurgical treatment options are most appropriate in management of these lesions. IPTs often recur locally, while distant metastases are very rare. Postoperative close surveillance is essential to detect recurrences early.
“…The use of nonsteroidal anti-inflammatory drugs, steroids, chemotherapy, radiotherapy, and tyrosine kinase inhibitors have been reported in the literature. 14,15 Since the surgical excision of the IMT, this patient has done remarkably well. She noted that all of her symptoms resolved shortly after surgery, and at her 3-month follow-up appointment in the oncology clinic, she continued to be asymptomatic, including resolution of her fatigue, sensory symptoms, and weight loss.…”
Section: Figurementioning
confidence: 89%
“…Close follow-up after excision is critical because recurrence rates for extrapulmonary lesions have been reported as high as 25%, 11 and this most commonly occurs in the first year (15%-40%). 14 There are no standardized guidelines regarding recommended monitoring of patients with IMT. There is no consensus on how to treat patients with incomplete resection, metastasis, or recurrence.…”
Dr Toner was a pediatric chief resident at the time of this case and submission, reviewed the patient's case retrospectively (given her interest in hematology and/or oncology), presented at a hospital wide multidisciplinary conference, and provided revisions to the manuscript; Dr Srinivasalu is a rheumatology attending who cared for this patient in the outpatient setting and continues to manage her case and provided revisions to the manuscript; Dr Guerrera is a hematology attending who consulted on this patient's case while she was admitted as an inpatient to the adolescent medicine inpatient service and provided revisions to the manuscript; Ms Shirron is a gastroenterology nurse practitioner who consulted on this patient's case while she was admitted as an inpatient to the adolescent medicine inpatient service and provided revisions to the manuscript; Dr Diamond is a hematology-oncology fellow who has managed this patient both in the inpatient and outpatient settings and provided revisions to the manuscript; Dr Bandarkar is a radiology attending who read the initial imaging studies done on this patient and provided revisions to the manuscript; Dr Chokshi is an outpatient attending and the primary care physician for this patient and provided revisions to the manuscript; and all authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work
“…The use of nonsteroidal anti-inflammatory drugs, steroids, chemotherapy, radiotherapy, and tyrosine kinase inhibitors have been reported in the literature. 14,15 Since the surgical excision of the IMT, this patient has done remarkably well. She noted that all of her symptoms resolved shortly after surgery, and at her 3-month follow-up appointment in the oncology clinic, she continued to be asymptomatic, including resolution of her fatigue, sensory symptoms, and weight loss.…”
Section: Figurementioning
confidence: 89%
“…Close follow-up after excision is critical because recurrence rates for extrapulmonary lesions have been reported as high as 25%, 11 and this most commonly occurs in the first year (15%-40%). 14 There are no standardized guidelines regarding recommended monitoring of patients with IMT. There is no consensus on how to treat patients with incomplete resection, metastasis, or recurrence.…”
Dr Toner was a pediatric chief resident at the time of this case and submission, reviewed the patient's case retrospectively (given her interest in hematology and/or oncology), presented at a hospital wide multidisciplinary conference, and provided revisions to the manuscript; Dr Srinivasalu is a rheumatology attending who cared for this patient in the outpatient setting and continues to manage her case and provided revisions to the manuscript; Dr Guerrera is a hematology attending who consulted on this patient's case while she was admitted as an inpatient to the adolescent medicine inpatient service and provided revisions to the manuscript; Ms Shirron is a gastroenterology nurse practitioner who consulted on this patient's case while she was admitted as an inpatient to the adolescent medicine inpatient service and provided revisions to the manuscript; Dr Diamond is a hematology-oncology fellow who has managed this patient both in the inpatient and outpatient settings and provided revisions to the manuscript; Dr Bandarkar is a radiology attending who read the initial imaging studies done on this patient and provided revisions to the manuscript; Dr Chokshi is an outpatient attending and the primary care physician for this patient and provided revisions to the manuscript; and all authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work
“…IMTs have been observed predominantly in young patients and have been encountered virtually in any anatomical location such as the lungs [2], mesentery [4], omentum [3], retroperitoneum [5], extremities [6], head [7], liver [10], spleen [11], thyroid [12], and urinary bladder [13]. Notably, reported cases on IMTs/IPTs of the breast are very scarce [1, 9, 14–34].…”
Inflammatory myofibroblastic tumors (IMTs) of the breast represent extremely rare lesions. Due to the scarcity of reports, their natural history, recurrence, and metastatic potential remain poorly defined. We report on a case of a primary breast IMT in a postmenopausal female patient treated successfully with breast conserving surgery and review the literature pertaining to this rare entity.
“…On MRI, as discussed by Yagmur et al [ 28 ], IMTs exhibit intermediate signal intensity in T1-weighted images and high signal intensity in T2-weighted images. These lesions are characterized by high 18 F-FDG PET uptake, similar to malignant tumors; their greater SUV max is attributable to the large number of inflammatory cells within IMTs [ 28 , 29 ]. In most instances, a definitive diagnosis is made based on the histopathological and immunohistochemical findings performed on the resected tumor.…”
Section: Discussionmentioning
confidence: 99%
“…Complete surgical resection of abdominal IMTs remains the mainstay of treatment associated with a low rate of recurrence. Final diagnosis should be based on histopathological and immunohistochemical findings [ 28 ]. A careful 1-year follow-up is recommended for early recurrence.…”
Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm of intermediate biologic potential, with uncertain etiology. This tumor occurs primarily in the lung, but the tumor may affect any organ system. A 75-year-old male was evaluated for voluminous palpable high abdominal mass with continuous and moderately abdominal pain, associated with abdominal distension for the last two months. Abdominal computed tomography showed a large (32 × 29 × 15 cm) heterogeneously enhanced mass with well-defined margins. At surgery, the mass originated from the greater omentum was completely excised. Histologically the tumor was a mesenchymal neoplasm in smooth muscle differentiation and was characterized by spindle-cell proliferation with lymphocytes, plasma cells, and rare eosinophils. Immunohistochemically, the tumor cells were positive for vimentin and smooth muscle actin and negative for anaplastic lymphoma kinase. Complete surgical resection of IMTs remains the mainstay of treatment associated with a low rate of recurrence. Final diagnosis should be based on histopathological and immunohistochemical findings. Appropriate awareness should be exercised by surgeons to abdominal IMTs in combination with constitutional symptoms, abnormal hematologic findings, and radiological definition, to avoid misdiagnosed.
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