Synchronous Inflammatory Myofibroblastic Tumor in Lung and Brain: A Case Report and Review of Literature

Jehangir, Maham; Jang, Aisha; Rehman, Ur; Mamoon, Nadira

doi:10.7759/cureus.1183

Cited by 8 publications

(5 citation statements)

References 7 publications

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“…suggested that patients with IMT in the lungs should be screened for brain lesions even if asymptomatic. [ 20 ] In our study, 12.5% of cases with follow-up data developed brain metastasis. Very rarely, IMT may show sarcomatous transformation, as in one patient of our study [ Figure 8 ].…”

Section: Discussionmentioning

confidence: 51%

Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation

Irodi

Chacko

Prajapati

et al. 2020

Indian Journal of Radiology and Imaging

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Context and Aims: Inflammatory myofibroblastic tumour (IMT) is a rare mesenchymal neoplasm with intermediate malignant potential. The aim of this study is to describe and compare the clinical presentation, computed tomography (CT) findings and anaplastic lymphoma kinase -1 (ALK-1) expression of IMT of the thorax in children and adults. We also sought to study the tumour behaviour after treatment on the follow-up imaging. Materials and Method: This is a retrospective observational study of 22 histopathologically proven cases of IMT in the thorax. The clinical parameters, CT findings, biopsy results, treatment received and follow-up were recorded. Statistical analysis was performed using Fisher's exact test. Results: IMT of the thorax had diverse imaging appearances, presenting either as large invasive lung masses with or without calcifications or as smaller endobronchial lesions. Children commonly presented with long duration fever ( P = 0.02) and large invasive lung masses ( P = 0.026), whereas adults presented with long duration haemoptysis ( P = 0.001) and endobronchial lesions or smaller lung parenchymal lesions. Calcifications were more common in children ( P = 0.007). ALK-1 was positive in 40% of children and 18.2% of adults ( P = 0.547). Endobronchial lesions showed a trend for ALK-1 negativity. Patients with bronchoscopic excision had local recurrence and patients with surgical wedge resection had metastatic brain lesions as compared to those with lobectomy and pneumonectomy ( P = 0.0152). A patient with unresectable lung mass had malignant transformation to spindle cell sarcoma after 9.5 years. Conclusions: Thoracic IMT presents with some distinct clinical and CT findings in adults and children. The CT findings and management options have implications for prognosis. If resectable, lobectomy is a better option than wedge resection or bronchoscopic excision for preventing local recurrence and metastasis. IMT can undergo malignant transformation.

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Section: Discussionmentioning

confidence: 51%

Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation

Irodi

Chacko

Prajapati

et al. 2020

Indian Journal of Radiology and Imaging

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“…Rare cases of the coexistence of pulmonary and brain IMTs have been reported, where it was not clear whether the brain lesion was metastatic or part of multifocal disease [10]. Jehangir et al suggested that patients with IMT in the lungs should be screened for brain metastasis even if asymptomatic [10]. Our patient developed a rapid local recurrence, followed by spinal and brain metastasis within a short interval of six to eight months.…”

Section: Discussionmentioning

confidence: 66%

“…In a study by Irodi et al,12.5% of cases of thoracic IMT developed brain metastasis on follow-up [9]. Rare cases of the coexistence of pulmonary and brain IMTs have been reported, where it was not clear whether the brain lesion was metastatic or part of multifocal disease [10]. Jehangir et al suggested that patients with IMT in the lungs should be screened for brain metastasis even if asymptomatic [10].…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Myofibroblastic Tumor With Rapid Recurrence and Distant Metastasis: Report of a Rare Case

Kalita,

Rastogi,

Bhatnagar

et al. 2024

Cureus

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Inflammatory myofibroblastic tumors (IMTs) are rare spindle cell tumors clinically, morphologically, and genetically heterogeneous, mimicking many other reactive and neoplastic lesions and creating great diagnostic problems. Although it is generally characterized by oncogene-derived proliferation of myofibroblasts in a background of polyclonal inflammatory cell infiltrates, morphological variations do occur requiring immunohistochemistry and molecular genetics to confirm the diagnosis. It encompasses a wide age range, and locations, mostly said to be of intermediate grade having a low risk of recurrence and metastasis. However, its biological behavior and course are variable and unpredictable.Here, we report a case of thoracic IMT in a 32-year-old adult female presenting with a history of fever, cough, and chest pain associated with neutrophilic leukocytosis. Radiological investigations revealed a large mass in the thoracic region with possibilities of hydatid cyst and neurogenic tumor. Initial core needle biopsy specimen and subsequent local resection specimen revealed the diagnosis of IMT on histopathology and immunohistochemistry, having conventional morphology with expression of Anaplastic lymphoma kinase (ALK) protein. The patient developed rapid local recurrence and was started with first-generation ALK inhibitor Crizotinib. After a brief period of response, she developed vertebral and brain metastasis within a short span of time and was switched to a third-generation ALK inhibitor, Lorlatinib. The patient is on regular follow-up, has stable disease, and maintains a good quality of life after two years of diagnosis.

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“…They usually involve cutaneous and subcutaneous tissues [1] . Less common locations include bones and internal organs: lung, heart, gastrointestinal tract, and central nervous system [5] , [6] , [7] , [8] .…”

Section: Discussionmentioning

confidence: 99%

Multiple pulmonary myofibromas mimicking metastatic disease in an adult patient

Morales-Cárdenas

Semionov

Kosiuk

2020

Radiology Case Reports

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We report a case of multiple bilateral pulmonary myofibromas in an asymptomatic 76-year-old man, who was referred to our institution for investiagtion of incidentally discovered pulmonary nodules, orginially suspected to represent pulmonary metastases. Myofibromas are unusual benign neoplasms, infrequent in adults, and rarely affecting the lungs. Pulmonary neurofibromas can mimic lung metastases and their diagnosis requires histopathological assessment.

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Synchronous Inflammatory Myofibroblastic Tumor in Lung and Brain: A Case Report and Review of Literature

Cited by 8 publications

References 7 publications

Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation

Inflammatory myofibroblastic tumours of the thorax: Radiologic and clinicopathological correlation

Inflammatory Myofibroblastic Tumor With Rapid Recurrence and Distant Metastasis: Report of a Rare Case

Multiple pulmonary myofibromas mimicking metastatic disease in an adult patient

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