Recurrent Left Atrial Low-grade Malignant Inflammatory Myofibroblastic Tumor Characterized by Cardiovascular Magnetic Resonance

Abstract

Background: Cardiac Inflammatory Myofibroblastic Tumor (IMT) is extremely rare, currently considered a tumor of borderline malignancy, with unpredictable clinical expression. IMT mimics malignant tumor in clinical presentation, imaging information, and histologic features, making diagnosis troublesome especially in the heart for its rarity. Histopathology is the gold standard for the diagnosis of cardiac IMT. Cardiovascular magnetic resonance (CMR) imaging is a useful tool for the diagnosis of IMT. It can also assist with intraoperative planning. Discussion: However, few researches report the application of CMR imaging in IMT. In our case, CMR results showed typically abundant vascularity and hemorrhage, which may be the characteristic manifestations of IMT. These possible CMR characteristics of IMT could provide basic information for further studies. To date, only 58 cases of cardiac IMT including 4 recurrence cases were reported in the published English paper. We herein present an adolescent girl who presented with similar entity involving left atrium and early recurrence at the same site after subtotal surgical resection. Conclusion: Moreover, recurrence was more likely to occur in patients with incomplete resection. Key Points: Key point 1: Cardiac Inflammatory Myofibroblastic Tumor (IMT) is extremely rare. Key point 2: CMR imaging is a useful tool for the diagnosis and intraoperative planning. Keypoint 3: Few research reports the application of CMR imaging in IMT. Keywords: Cardiac tumor, Cardiovascular Magnetic Resonance (CMR), Inflammatory Myofibroblastic Tumor (IMT), inflammatory pseudotumor, recurrent tumor, malignancy.