Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 14 , ISSUE 5 ( September-October, 2022 ) > List of Articles

CASE REPORT

Inflammatory Myofibroblastic Tumor of the Uterus: An Under-recognized Entity—A Case Report and Literature Review

Balamurugan Senthilnayagam, S Manjani, S Preethi, K Khowsalya Subrajaa

Keywords : Inflammatory myofibroblastic tumor, Mesenchymal tumor uterus, Uterus

Citation Information : Senthilnayagam B, Manjani S, Preethi S, Subrajaa KK. Inflammatory Myofibroblastic Tumor of the Uterus: An Under-recognized Entity—A Case Report and Literature Review. J South Asian Feder Obs Gynae 2022; 14 (5):621-622.

DOI: 10.5005/jp-journals-10006-2128

License: CC BY-NC 4.0

Published Online: 16-11-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: We report an uncommon case of uterine inflammatory myofibroblastic tumor (IMT), a unique mesenchymal tumor often misdiagnosed as “fibroid uterus” on radiology. Background: Inflammatory myofibroblastic tumor is a mesenchymal tumor reported in the lungs, mesentery, omentum, and retroperitoneum. Its occurrence in the uterus is rare and is often misidentified as a smooth muscle or endometrial stromal tumor. Herein, we report a case of IMT of the uterus. Case description: A 33-year-old lady presented to the OP with menorrhagia. USG abdomen was reported as bulky uterus with an intra-mural (8.7 × 7 cm) fibroid arising from the anterior myometrium. No lymph nodes or free fluid noted. “Myomectomy” was done under spinal anesthesia, and the specimen was sent for HPE. Grossly, it was a circumscribed gray–white soft-tissue mass mimicking a leiomyoma. However, microscopy of the mass was rather unusual to call it a leiomyoma. It had a “tissue-culture-like” or “nodular fasciitis-like” appearance. There were spindle cells in fascicles and prominent myxoid change with lymphoplasmacytic infiltrate. No nuclear atypia, necrosis, or infiltrative margins were noted. So, a morphological diagnosis of IMT was made. Conclusion: The case is reported for its diagnostic challenge and rarity. Clinical significance: Inflammatory myofibroblastic tumors are uncommon mesenchymal tumors of low malignant potential with a tendency to recur and rare metastases. Surgical excision is the treatment of choice. Recurrent IMTs can be treated with ALK-based targeted therapy.


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