Aggressive Inflammatory Myofibroblastic Tumor without Anaplastic Lymphoma Kinase Gene Rearrangement in the Rectum with Liver Metastasis

Intern Med. 2020 Feb 15;59(4):495-499. doi: 10.2169/internalmedicine.3686-19. Epub 2019 Oct 7.

Abstract

Inflammatory myofibroblastic tumor is a rare intermediate-grade tumor. We herein report the case of an 81-year-old man with rectal ulceration and abnormal retroperitoneal soft tissue with a high serum level of IgG4. The administration of prednisolone reduced the retroperitoneal lesion; however, the rectal ulceration expanded. Surgical resection was performed. A histopathological examination revealed proliferating spindle cells accompanied by inflammatory cells and plasma cells. Liver metastasis emerged two months after surgical resection, and the histology of the proliferating spindle cells sampled by a fine-needle biopsy was similar to that of the rectal tissue. The patient ultimately died of inflammatory myofibroblastic tumor.

Keywords: ALK; IgG4; inflammatory myofibroblastic tumor; liver metastasis; rectum.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anti-Inflammatory Agents / therapeutic use*
  • Fatal Outcome
  • Humans
  • Liver Neoplasms / complications*
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery*
  • Lymphoma / mortality
  • Lymphoma / physiopathology*
  • Male
  • Neoplasm Metastasis / physiopathology*
  • Prednisolone / therapeutic use*
  • Rectal Neoplasms / drug therapy*
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / physiopathology

Substances

  • Anti-Inflammatory Agents
  • Prednisolone