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

Can Chen,Jun He,Mengjun Huang,Mingke Liu,Shuiqing Wu,Ran Xu,Haiqing He,Hongjing Zang

doi:10.3389/fmed.2022.831952

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.

Highlights

An inflammatory myofibroblastic tumor (IMT) is a rare tumor made up of spindle cells with an associated inflammatory cell infiltrate [1]
The specific pathogenesis and etiology of IMT remain uncertain and might be connected with the following factors [4, 7, 10, 11]: chronic inflammatory stimulation resulting from bacterial and viral microorganisms, history of bladder trauma or long-term use of hormone therapy, and rearrangements of the anaplastic lymphoma kinase (ALK) gene located on chromosome 2p23
The disease is mainly treated with transurethral resection of bladder tumor (TURBT) and partial cystectomy to completely remove the tumor

Summary

Introduction

An inflammatory myofibroblastic tumor (IMT) is a rare tumor made up of spindle cells with an associated inflammatory cell infiltrate [1]. The pathogenesis and malignancy potential of the disease remain unclear [1, 2]. The disease can occur anywhere in the body but is most commonly seen in the lungs, mesentery, and omentum [3, 4]. IMT is more likely to be found in the bladder. In previous literature, this disease has been reported in

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