Inflammatory Myofibroblastic Tumor Of Bladder Research Articles

Inflammatory myofibroblastic tumor of the bladder: Computed tomographic features.

Inflammatory myofibroblastic tumor (IMT) is a rare tumor with intermediate biologic potential, in which lack of understanding often poses difficulties in preoperative diagnosis and treatment. The aim of the present study was to characterize the computed tomography (CT) features of the bladder IMT. The CT images of nine pathologically confirmed bladder IMT were retrospectively reviewed. All patients underwent both unenhanced CT and contrast-enhanced CT. The diameter, location, contour, growth pattern, margin, boundary, density and enhancement pattern of the lesions were assessed. The mean Ki67 value of an irregular blood clot was 18% and that of no blood clot was 12%. A total of eight (89%) patients had one tumor and 1 (11%) patient had multiple tumors. An endophytic growth pattern was observed in 4 (44%) patients, an exophytic growth pattern in 2 (22%) patients, and a mixed growth pattern in 3 (33%) patients. The tumor manifests morphologically as either polypoid (n=5), or cauliflower-like (n=1) soft-tissue mass with a wide base in the cavity, or a limited thick-walled (n=3). The tumor margins were smooth (n=8) or lobulated (n=1), and the tumor boundaries were either clear (n=7) or ill-defined (n=2). The lesions showed either ring-shaped (n=3) or heterogeneous (n=6). The polypoid and cauliflower-like soft-tissue mass showed a symmetrical change in the center of the lesion after enhancement. The bladder IMT is mostly a single polypoid nodule in the superior wall, mostly endophytic growth, with ring-haped enhancement and symmetrical change after enhancement as its characteristic manifestations.

Inflammatory Myofibroblastic Tumor in Bladder with Multiple Vesicocutaneous Fistula in Pediatric Patient: A Rare Case Report

Inflammatory myofibroblastic tumor (IMT) is a rare tumor that occurs at any age from childhood to late adulthood and may have a slight male predilection. A 7-year-old female presented with gross hematuria and a lump in the lower abdomen since 1 month prior to admission. The complaints were also accompanied by weight loss, abdominal pain and anemia. Ultrasound examination, Cystography, CT-Scan and MRI showed that mass in the bladder. Histopathology examination confirmed diagnosis for IMT, thus, radiology plays an important role in supporting histologic examination for diagnosis and evaluation of IMT.

Bladder inflammatory myofibroblastic tumor: report of four cases

BackgroundInflammatory myofibroblastic tumor (IMT) of the bladder (BIMT) is a rare entity with non-specific symptoms and particular histological features. Though bladder location is very uncommon, it arises from the bladder submucosal stroma as a polypoidal growth and is easily mistaken clinically, radiologically and histologically with a malignant neoplasm. The main treatment is surgical resection. To our knowledge, few reports of this pathology have been duly informed in Latin America to date.Case presentationWe present four case male patients evidencing bladder tumor initially treated with transurethral bladder resection, diagnosing BIMT. They had shown tumor recurrence and laparoscopic treatment were decided without evidence of new recurrence.ConclusionDue to the few reports of this pathology, specially in South America, it is important to know its therapeutic management and follow-up.

Inflammatory myofibroblastic tumor of the urinary bladder: treatment and a two-year monitoring - case report

Introduction. Inflammatory myofibroblastic tumor of the bladder or inflammatory pseudotumor is benign in nature. It is also known as a pseudotumor, because it macroscopically mimics infiltrative tumors of the bladder. The first inflammatory pseudotumor ever described was found in the lungs. In the 80s of the last century, it was first described in the urinary bladder. Its etiology is unknown and the incidence is extremely rare. Case Report. We present a case of a 46-year-old man who came to the Emergency Center for the first time due to an unpleasant feeling when urinating, painless hematuria and appearance of blood clots during urination. An urgent diagnosis revealed a tumor mass in the bladder. Additional diagnostics and surgical treatment was performed by transurethral electroresection of the urinary bladder. After the histopathological examination, an inflammatory myofibroblastic tumor of the bladder was diagnosed. The patient was discharged on the third day of admission. On control examinations, the patient underwent only cystoscopy and ultrasonography. No recurrences were observed. Conclusion. A review of the available literature showed that in such cases, after transurethral resection of bladder tumor, most urologists opted for more radical surgical procedures. After a two-year follow-up, we proved that a tumor of the bladder can be kept under control after transurethral resection of bladder tumor, without recurrence, by regular monitoring using ultrasonography and cystoscopy.

Urinary Bladder Inflammatory Myofibroblastic Tumor With Mutated TP53 and PPFIBP1-ALK Gene Fusion

Abstract Inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm with distinct histologic features. Approximately 50% of these tumors harbor ALK gene rearrangements with multiple gene fusion partners described, a few of which are predictive of poor prognosis. One example is the ALK-RANBP2 gene rearrangement identified in cases of epithelioid myofibroblastic sarcomas. Many studies have attempted to identify other immunohistochemical or molecular features, which may be predictive of outcome, with conflicting results, particularly regarding the expression of p53. In addition, aberrant p53 expression may be used to favor a diagnosis of leiomyosarcoma over IMT. We present the case of a deeply invasive urinary bladder IMT with aberrant p53 expression and corresponding TP53 genomic alteration, the latter previously reported in only 2 unrelated cases of malignancy. Our case highlights that p53 aberrant expression and TP53 genomic alterations may be found in IMTs and may be related to IMT pathogenesis and prognosis. Furthermore, relying on absence of aberrant p53 expression in IMT in order to distinguish it from histologic mimickers may lead to potential diagnostic pitfalls. In addition, our case demonstrated weak immunohistochemical staining for ALK and was found to harbor a PPFIBP1-ALK gene fusion, previously described in only 2 reports of IMTs of the lung, also with associated negative or weak immunohistochemical staining for ALK.

Explore the characteristics of bladder function of the patients with pelvic organ malignancy

Explore the characteristics of bladder function of the patients with pelvic organ malignancy

Inflammatory Myofibroblastic Tumor of the Bladder

We illustrate a case of an inflammatory myofibroblastic tumor (IMT) involving the bladder in a woman with dysuria and review the literature and differential diagnosis. Inflammatory myofibroblastic tumor, also referred to as pseudosarcomatous myofibroblastic proliferation, is a rare lesion that can arise in the genitourinary system and is characterized by a fascicular arrangement of myofibroblasts with admixed inflammatory cells and slitlike vessels. Urinary bladder IMT can be a diagnostic pitfall because its histologic features (brisk mitoses, invasion into muscularis propria, and prominent nucleoli) can mimic malignancy. The differential diagnosis of urinary bladder IMT includes sarcomatoid carcinoma and leiomyosarcoma. Diagnostic features such as bland nuclear chromatin, ganglion-like cells, pale eosinophilic cytoplasm with long processes, overexpression of anaplastic lymphoma kinase (immunohistochemistry or gene rearrangement studies), and the absence of atypical mitoses help distinguish IMT from its malignant mimics. Current controversies regarding postoperative spindle cell nodule and IMT are discussed.

Inflammatory myofibroblastic tumor of the bladder: case report and review of the literature

Inflammatory myofibroblastic tumour (IMT) is a rare tumour with malignant potential, and has been described in many major organs. However, bladder location is very uncommon. We report the case of a 23-year-old woman who presented with painless gross hematuria for 2 weeks. Contrast-enhanced computed tomography revealed a bladder tumour. The patient underwent an open partial cystectomy and the final pathologic diagnosis was IMT of bladder. Typical IMTs can be locally aggressive, therefore close follow-up is necessary.

Inflammatory myofibroblastic tumor of the bladder

Objective To review the pathological and clinical features of inflammatory myofibroblastic tumor(IMT)of the bladder,and to discuss its diagnosis,treatment and prognosis.Methods The clinicaldata of 7 patients with IMT of the bladder were reviewed.There were 3 males and 4 females aged 10 to 54 years(mean 38).Lesions were 1.5 cm to 5.0 cm.The majority of the patients presented with hematuria.The masses of bladders were discovered by imaging studies and cystoscopys.Three cystoscopic biopsies and frozen section analysis of 2 specimens were performed,but no IMT was confirmed.Results All bladder IMTs were managed by partial cystectomy.By post-operative pathological examination,IMT of the bladder were diagnosed.By immunohistochemistry,lesions at least fotally expressed smooth muscle actin(7/7),AE1/AE3(7/7),vimentin(7/7).anaplastic lymphoma kinase(6/7),and most lacked S100(0/7),CD_(34)(017),CD_(117)(0/7).Follow-ups were available in 6 cases.There was no patient with recurrence during the follow up from 1 month to 60 months.Conclusions The IMT of the bladder is rare.The diagnosis mainly depends on pathological diagnosis.Partial cystectomy or transurethral resection could be the treatment choice. Key words: Urinary bladder neoplasms; Neoplasms,muscle tissue; Diagnosis; Therapy

Inflammatory myofibroblastic tumor of bladder: a clinicopathologic study of five cases

To study the clinicopathologic features, diagnosis and differential diagnosis of inflammatory myofibroblastic tumor of the urinary bladder. Excisional specimens from 5 cases of vesical inflammatory myofibroblastic tumor were studied by light microscopy and immunohistochemistry (EnVision). The clinical data were also analyzed. Among the 5 patients studied, 3 were males and 2 were females. The age of the patients ranged from 10 to 53 years (mean age = 35 years). The most common clinical presentation was micturition pain and hematuria. Three cases were located at the dome of the urinary bladder and the remaining 2 cases were found in the left lateral wall. Histologically, the tumor varied from myxoid to highly cellular. The tumor cells were spindle to stellate in shape, widely separated or showed a compact fascicular pattern. There were often associated with mixed inflammatory infiltrates and an irregular meshwork of small dilated vessels. Immunohistochemical study showed that the tumor cells expressed AE1/AE3 (5/5), vimentin (5/5), smooth muscle actin (5/5), calponin (5/5), caldesmon (3/5), desmin (4/5) and anaplastic lymphoma kinase protein (4/5). Follow-up data were available in 4 patients and none had local recurrence or died of this disease. Inflammatory myofibroblastic tumour of urinary bladder is a rarely encountered but distinctive neoplasm with intermediate malignant potential.

Successful Preoperative Treatment of Pediatric Bladder Inflammatory Myofibroblastic Tumor with Anti-Inflammatory Therapy

Inflammatory myofibroblastic tumors are rare, locally invasive tumors that can involve the genitourinary tract. Therapy has consisted primarily of surgery, and anecdotal experience using both chemotherapy and radiotherapy, which have yielded unimpressive results. We report the first case of a bladder inflammatory myofibroblastic tumor that responded to an anti-inflammatory regimen (prednisone and Cox-2 inhibitor) before surgical extirpation.

Inflammatory Myofibroblastic Tumors of the Urinary Tract: A Clinicopathologic Study of 46 Cases, Including a Malignant Example Inflammatory Fibrosarcoma and a Subset Associated With High-grade Urothelial Carcinoma

Inflammatory myofibroblastic tumor (IMT) of the urinary tract, also termed postoperative spindle cell nodule, inflammatory pseudotumor, and pseudosarcomatous fibromyxoid tumor, is rare and in the past was believed to reflect diverse entities. We reviewed a series of 46 IMTs arising in the ureter, bladder, and prostate, derived primarily from a large consultation practice. There were 30 male and 16 females aged 3 to 89 years (mean 53.6). Lesions were 1.2 to 12 cm (mean 4.2). There was a history of recent prior instrumentation in 8 cases. Morphology was similar to that previously described for IMT occurring in this region, with the exception of 1 case that focally appeared sarcomatous. Polypoid cystitis coexisted in 5 patients (11%). Mitoses were typically scant (0 to 20/10 hpf, mean 1). Necrosis was seen in 14 (30%) cases. Invasion of the muscularis propria was documented in 19 (41%). By immunohistochemistry (IHC), lesions at least focally expressed anaplastic lymphoma kinase (ALK) (20/35, 57%), AE1/3 (25/34, 73%), CAM5.2 (10/15, 67%), CK18 (6/6, 100%), actin (23/25, 92%), desmin (15/19, 79%), calponin (6/7, 86%), caldesmon (4/7, 57%, rare cells), p53 (10/13, 77%), and most lacked S100 (0/14), CD34 (0/13), CD117 (2/13, 15%), CD21 (0/5), and CD23 (0/3). ALK gene alterations were detected by fluorescence in situ hybridization (FISH) in 13/18 (72%) tested cases, including 2 with prior instrumentation; 13/18 (72%) showed agreement between FISH ALK results and ALK protein results by IHC. Most bladder IMTs were managed locally, but partial cystectomy was performed as the initial management in 7 cases and cystectomy in 1 (1 IMT was initially misinterpreted as carcinoma, 1 IMT was found incidentally as a separate lesion in a cystectomy specimen performed for urothelial carcinoma). Follow-up was available in 32 cases (range 3 to 120 mo; mean 33; median 24). There were 10 patients with recurrences (2 with 2 recurrences). Recurrences were unassociated with muscle invasion or with ALK alterations. In 2 cases, tumors of the urinary tract (TURs) showing IMT preceded (1 and 2 mo, respectively) TURs showing sarcomatoid carcinoma with high-grade invasive urothelial carcinoma accompanied with separate fragments of IMT. Even on re-review the IMT in these 2 cases were morphologically indistinguishable from other cases of IMT, with FISH demonstrating ALK alterations in the IMT areas in one of them. Both these patients died of their carcinomas. Lastly, there was 1 tumor with many morphological features of IMT and an ALK rearrangement, yet overtly sarcomatous. This case arose postirradiation for prostate cancer 4 years before the development of the lesion, with tumor recurrence at 4 months and death from intra-abdominal metastatic disease at 9 months. In summary, urinary tract IMTs are rare and share many features with counterparts in other sites, displaying similar morphology and immunogenotypic features whether de novo or postinstrumentation. Typical IMTs can be locally aggressive, sometimes requiring radical surgical resection, but none of our typical cases metastasized, although they can rarely arise contemporaneously with sarcomatoid urothelial carcinomas. For these reasons, close follow-up is warranted.

ALK-1 Expression in Inflammatory Myofibroblastic Tumor of the Urinary Bladder

Inflammatory myofibroblastic tumor (IMT) of the bladder is an uncommon myofibroblastic spindle cell proliferation. Because of its cytologic features and infiltrative nature, it may be difficult to distinguish histologically from sarcomatous proliferations such as sarcomatoid urothelial carcinoma, leiomyosarcoma, and embryonal rhabdomyosarcoma. Recently, anaplastic lymphoma kinase (ALK) gene translocations or ALK protein expression in IMT has been reported, especially in patients of relatively young ages. However, there are only a few reports mentioning IMT of the bladder. We sought to determine the frequency of ALK expression among IMTs of the urinary bladder. We examined 16 cases of IMTof the bladder in 14 patients to elucidate the incidence of ALK-1 expression by immunohistochemistry and its diagnostic usefulness. The age of patients with IMT ranged from 18 to 76 years, with an average age of 42.8 years. The tumors from 10 of 14 patients (12 of 16 cases) were positive for ALK-1. ALK-1-positive cases ranged in age from 18 to 73 years (mean, 39.2 years; median, 38 years) and ALK-1-negative cases from 41 to 76 years (mean, 41.5 years; median, 44.5 years). Two locally recurrent cases were positive for ALK-1 in both the primary and recurrent lesion. ALK-1 immunostaining was detected only in the cytoplasm, with granular or subplasmalemmal linear features, suggesting ALK gene translocation. ALK-1 immunostaining was also performed in 8 sarcomatoid urothelial carcinomas, 5 genitourinary leiomyosarcomas, and 2 stromal tumors of uncertain malignant potential of the prostate, all of which were negative. These results support that ALK-1 immunostaining is useful to differentiate IMT from other malignant spindle cell neoplasms of the bladder. There were no histologic differences between ALK-1 positive and negative IMTs.