DOI: 10.4274/uob.534
Bulletin of Urooncology 2016;15:38-40
38
Retroperitoneal İnfamatuvar Miyofbroblastik Tümör:
Olgu Sunumu ve Literatür Taraması
Retroperitoneal Inflammatory Myofibroblastic Tumor:
A Rare Case Report and Literature Review
Address for Correspondence/Yaz›flma Adresi: Oktay Üçer MD, Celal Bayar University Faculty of Medicine, Department of Urology, Manisa, Turkey
Phone.: +90 505 211 46 18 E-mail: uceroktay@yahoo.com
Received/Geliş Tarihi: 27.11.2015 Accepted/Kabul Tarihi: 04.12.2015
© Bulletin of Urooncology, Published by Galenos Publishing. / © Üroonkoloji Bülteni, Galenos Yayınevi tarafından basılmıştır.
1
Celal Bayar University, Faculty of Medicine, Department of Urology, Manisa, Turkey
2
Celal Bayar University Faculty of Medicine, Department of Pathology, Manisa, Turkey
Oktay Üçer MD
1
, Mehmet Yüksel MD
1
, Gökhan Temeltaş MD
1
, Peyker Temiz MD
2
, Talha Müezzinoğlu MD
1
Introduction
The inflammatory myofibroblastic tumor (IMT), also known as
inflammatory pseudotumor, is an uncommon tumor characterized
by a controversial etiology, various histopathological features,
and an unpredictable biological behavior (1). The profile of this
disease has changed with time from benign reactive process
to a malignant neoplasm, based on the multiple case reports
demonstrating recurrent and constant clonal genetic alterations
(2). There are three main histological patterns; nodular fasciitis-
like, fibrous histiocytoma-like, and desmoid or scar tissue-type
(3). IMT is usually diagnosed in adults in the lungs. It is also
described in the other locations, such as the kidney, orbit, liver,
pancreas, spleen mesentery and limbs and may also be seen
during childhood (4). However, retroperitoneal location is rarely
reported in literature.
Case Report
The patient is a 52-year old woman with a history of abdominal
lump and complaint of exhaustion for two years, and with
no history of urinary tract symptoms. She had no history of
abdominal trauma, or urinary tract infection, but she underwnt
umbilical hernia repair 5 years ago. Physical examination did
not reveal any pathological findings. Blood count parameters
were within normal limits except low hemoglobin rate
(hemoglobin: 11.7). C-reactive protein and tumor markers
were also negative. Contrast-enhanced computed tomography
revealed an 84x78x106 mm mass on the right side, located
inferior to the adrenal gland, and posterior to the kidney (Figure
1). It seemed to be separate from the kidney tissue. Tru-cut
biopsy was performed; Histopathological examination revealed
connective tissue infiltrated by T and B lymphocytes and
enlarged vascular structures. There were no tumor cells seen
Primary retroperitoneal inflammatory myofibroblastic tumors (IMT) are
a very rare clinical condition. Herein, we present a case of IMT in the
retroperitoneal area. A 52-year-old woman presented with abdominal
lump and exhaustion. On physical examination, there was no
pathological finding. The diagnostic workup included contrast computer
tomography that revealed a 10,5-cm heterogeneous retroperitoneal
mass under the right adrenal gland, localized behind the right kidney.
At laparotomy, the mass arising from the retroperitoneum was excised.
Histopathology showed an IMT. IMTs has a variable biologic behavior
that ranges from the frequently benign lesions to more aggressive
variants. Final diagnosis is based on histomorphological features.
Complete surgical excision should be the aim of the curative treatment.
Keywords: Retroperitoneum, myofibroblastic tumor, inflammatory
myofibroblastic tumor
Summary
Primer retroperitoneal inflamatuvar miyofibroblastik tümörler (İMT)
klinikte oldukça nadir görülür. Burada retroperitoneal alandaki İMT olgusu
sunuldu. Elli iki yaşında kadın hasta batında kitle ve halsizlik şikayetleriyle
başvurdu. Fizik muayenesinde patolojik bir bulgu saptanmadı. Kontrastlı
bilgisayarlı tomografisinde retroperitonda sağ adrenal bezin altında ve
böbreğin arkasında 10,5 cm çaplı heterojen kitle görüldü. Kitle cerrahi
olarak eksize edildi ve patolojisi İMT geldi. İMT kötü huylu lezyonlardan
daha agresif özellikler taşıyana kadar değişik şekillerde görülebilmektedir.
Kesin tanı histopatolojik olarak konulmaktadır. Küratif tedavideki amaç
kitlenin tam cerrahi eksizyonudur.
Anahtar Kelimeler: Retroperiton, miyofibroblastik tümör, inflamatuvar
miyofibroblastik tümör
Öz
Case Report / Olgu Sunumu