A Rare Presentation of Inflammatory Myofibroblastic Tumor in the Nasolabial Fold

Abstract

Inflammatory myofibroblastic tumor (IMT) is a benign lesion that occurs most frequently in the soft tissues and viscera. In the head and neck region, the tumor has been reported to occur in the orbit, tongue, nasopharynx, larynx, and paranasal sinuses and the central nervous system. Despite being a benign lesion, it exhibits infiltrative and destructive behaviours, making histopathological examination necessary to confirm the diagnosis. We report the case of a 38-year-old female presented with a right nasolabial fold mass, which was confirmed histologically to be an IMT. Surgical excision of the mass was achieved through a sublabial approach with an uneventful postoperative period. To the best of our knowledge, this is the first reported case of an IMT in the nasolabial fold.

Figure 1

Magnetic resonance imaging. (a) Axial section shows well-defined subcutaneous soft tissue density located in the right nasolabial fold appearing isointensely on T1. (b) Hypointensity on T2. (c, d) Homogeneous enhancement after contrast.

Figure 2

Histopathological examination of the mass revealed (a) 100x microscopic image showing spindle cells proliferation, forming fascicles and whorls on a background of collagen fibres, and (b) 200x microscopic image showing mixed inflammatory cells infiltration in the background including plasma cells and eosinophils. (c) Spindle cells are focally positive for anaplastic lymphoma kinase (ALK) by immunohistochemistry. (d) Spindle cells are diffusely positive for smooth muscle actin (SMA) by immunohistochemistry.