Calcific Inflammatory myofibroblastic tumour in the retroperitoneum of a child: a case report

Authors

  • Bharati Pandya Department of Surgery, MGIMS, Sevagram, Wardha-442102, Maharashtra
  • Raju Gore Department of Surgery, MGIMS, Sevagram, Wardha-442102, Maharashtra
  • Ravinder Narang Department of Surgery, MGIMS, Sevagram, Wardha-442102, Maharashtra

Keywords:

Inflammatory myofibroblastic tumour, Retroperitoneum, Immunohistochemistry, Calcific fibrous pseudo-tumour

Abstract

Inflammatory Myofibroblastic Tumor (IMT) is a rare benign pseudosarcomatous lesion, characterized by inflammatory infiltrates admixed with myofibroblastic spindle cells. Initially only pulmonary locations were described, now extra-pulmonary sites are also well recognized. We present a case of a 3 year old female child who presented with history of flank pain, abdominal mass and intermittent fever of 1 year duration. Provisional diagnosis was neuroblastoma, but it turned out to be a retroperitoneal IMT with calcification. The patient was managed with surgical resection of the tumor and post-operative treatment with steroids as part of the tumour adherent to the inferior vena cava could not be resected. IMT is an uncommon neoplasm of uncertain biological potential. Both, retroperitoneal location and calcifications are rare presentations. Complete surgical resection remains the mainstay of treatment. Possible treatment of residual and recurrent tumours could be with steroids and anti-inflammatory drugs. Selected cases may need chemotherapy, the efficacy of which is not well documented. It has close resemblance to calcific fibrous pseudo-tumour and we have presented the differentiating features from review of literature.

References

Milos Bjelovic, Marjan Micev, Bratislav Spica, Tamara Babic, Dragan Gunjic, Aleksandra Djuric, et al. Primary inflammatory myofibroblastic tumor of the stomach in an adult woman: a case report and review of the literature. World J Surg Oncol. 2013;11:35.

Hojo H, Newton WA Jr, Hamoudi AB, Qualman SJ, Wakasa H, Suzuki S, et al. Pseudosarcomatous myofibroblastic tumor of the urinary bladder in children: a study of 11 cases with review of the literature. An Intergroup Rhabdomyosarcoma study. Am J Surg Pathol. 1995;19:1224-36.

Van Dorpe J, Ectors N, Geboes K, D’Hoore A, Sciot R. Is calcifying fibrous pseudotumor a late sclerosing stage of inflammatory myofibroblastic tumor? Am J Surg Pathol. 1999;23:329-35.

Fetsch JF, Montgomery EA, Meis JM. Calcifying fibrous pseudotumor. Am J Surg Pathol. 1993;17:502-8.

Germanidis G, Xanthakis I, Tsitouridis I, Zaramboukas T, Kiskinis D, Konstantaras C, et al. Regression of inflammatory myofibroblastic tumor of the gastrointestinal tract under infliximab treatment. Dig Dis Sci. 2005;50:262-5.

Brunn H. Two interesting benign lung tumors of contradictory histopathology. J Thorac Surg. 1939;9:119-31.

Coffin CM, Hornick J, Fletcher CD. Inflammatory myofibroblastic tumor: comparison of clinicopathologic, histologic, and immunohistochemical features including ALK expression in atypical and aggressive cases. Am J Surg Pathol. 2007;31:509-20.

Ozgur Firat, Safak Ozturk, Taner Akalin, Ahmet Coker. Inflammatory myofibroblastic tumour. Can J Surg. 2009 Jun;52(3):E60-1.

Berger A, Kim C, Hagstrom N, Ferrer F. Successful preoperative treatment of pediatric bladder inflammatory myofibroblastic tumor with anti-inflammatory therapy. Urology. 2007;70:372.e.13-5.

Kalisha A. Hill, Frank Gonzalez-Crussi, Pauline M Chou. Calcifying fibrous pseudotumor versus inflammatory myofibroblastic tumor: a histological and immunohistochemical comparison. Mod Pathol. 2001;14(8):784-90.

Coffin Cheryl M, Watterson Jan BA, Priest John R, Dehner Louis P. Extrapulmonary Inflammatory Myofibroblastic tumor (inflammatory pseudotumor) a clinicopathologic and immunohistochemical study of 84 cases. Am J Surg Pathol. 1995 Aug;19(8):859-72.

Downloads

Published

2016-12-13

Issue

Section

Case Reports