Open AccessAgressive inflammatory myofibroblastic tumor of the liver with underlying schistosomiasis: A case report
Author(s) -
Vera Lúcia Pannain,
Juliana Vial Passos,
Ariovaldo da Rocha Filho,
Cristiane Alves VillelaNogueira,
Adriana Caroli-Bottino
Publication year - 2010
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v16.i33.4233
Subject(s) - pathology , vimentin , medicine , metastasis , atypia , infiltration (hvac) , immunohistochemistry , inflammatory pseudotumor , lesion , granuloma , cancer , physics , thermodynamics
Inflammatory myofibroblastic tumor (IMT) occurs infrequently in the liver. It is controversial whether it represents a low grade mesenchymal neoplasm or a reactive inflammatory lesion. Local recurrence and metastasis are rare and some tumors are associated with infectious agents. We report on a case of a large and partially resected IMT with local recurrence and diaphragm and kidney infiltration detected on routine surveillance two years later. Histologically, the tumor showed spindle cells without atypia, mitosis or necrotic areas in a myxoid and collagenized background with inflammatory cells. In the liver portal tracts, granulomatous lesions with viable eggs of Schistosoma mansoni were identified. Immunohistochemistry demonstrated spindle cells which were smooth-muscle actin and vimentin positive. In conclusion, this case points out that these histological patterns do not predict the aggressive biological behavior of the lesion. A reason for the recurrence and the infiltration may be incomplete tumor resection. Further investigation is necessary in order to better clarify an infectious cause in some IMTs.