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Multicenter Study
. 2018 May 14:2018:5679634.
doi: 10.1155/2018/5679634. eCollection 2018.

The Clinical and Radiological Characteristics of Inflammatory Myofibroblastic Tumor Occurring at Unusual Sites

Xuewei Zeng  1 , Huayi Huang  1 , Jun Li  1 , Jiayou Peng  1 , Jiaxiong Zhang  1
Affiliations
Multicenter Study

The Clinical and Radiological Characteristics of Inflammatory Myofibroblastic Tumor Occurring at Unusual Sites

Xuewei Zeng et al. Biomed Res Int. .

Erratum in

Abstract

Inflammatory myofibroblastic tumor (IMT) can occur rarely in the soft tissue or joint of the limb. We retrospectively collected IMT cases of these rare sites and analyzed their clinical and imaging appearance. Thirteen cases of IMT were clinically diagnosed and underwent surgical procedures, pathological analyses, and postsurgical follow-up in our two hospitals. Other than one case of IMT of the bladder wall that presented with gross hematuria, none presented with local swelling, fever, or weakness. All the cases of IMT occurring at the bone showed destruction and parosteal soft tissue masses. The boundaries between the mass and normal bone were vague, without calcifications or any periosteal reaction. Five cases of IMF showed continuous enhancement on CT; seven cases demonstrated iso- or hyposignal intensity on T1WI; one case showed hypersignal intensity on T1WI, and eight cases demonstrated a hypersignal intensity signal on T2WI. All the masses located in soft tissues showed clear and sharp boundaries with different sizes of the swelling regions surrounding muscle interspaces. Three cases showed homogeneous enhancement, one case demonstrated heterogeneous enhancement, and two cases showed edge enhancement on enhanced MRI scans. On pathology, all the lesions showed an absence of a pseudocapsule, and four cases of ALK were positive. The radiological manifestations of IMT located at the soft tissue and bones were similar to benign tumors in shape; however, peritumoral edema, parosteal soft tissue, and the invasive rim of IMT are similar to the features of malignant tumors. Different radiological methods should be used to obtain an accurate diagnosis.

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Figures

Figure 1
Figure 1
Images obtained from a 44-year-old female with IMT of the right thigh. (a) An oval-shaped soft tissue mass in the right thigh with long T2 was observed. (b) An enhanced MRI scan revealed heterogeneous enhancement.
Figure 2
Figure 2
Images obtained from a 3-year-old female with IMT of the frontal bone. The CT scan showed destruction of the inner and outer plates, clear and sharp boundaries, and no calcification or ossification.
Figure 3
Figure 3
Typical radiological appearance of a 47-year-old man with IMT of the right groin. (a) An isodense, lobulated soft tissue mass in the right groin. (b) T2-weighted MRI showed a homogenous iso-signal mass. (c) Gadolinium-enhanced T1-weighted fat-suppression images showed heterogeneous enhancement (yellow arrow).
Figure 4
Figure 4
A 16-year-old female with IMT of the left thigh. (a) An oval-shaped soft tissue mass with short T1 and (b) long T2 signal was observed, with associated hemorrhage (red arrow) and vascular lesions (yellow arrow). (c) An enhanced MRI scan revealed rim enhancement.
Figure 5
Figure 5
Images obtained from a 48-year-old male. Lesions in the femur demonstrated expansive growth, with internal ground glass opacities, an unbroken sclerotic rim, and no cortical involvement on X-ray.
Figure 6
Figure 6
Images obtained from a 10-year-old female with IMT of the frontal bone. The CT scan showed destruction of the inner and outer plates, clear and sharp boundaries, and no calcification or ossification.
See this image and copyright information in PMC

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