Uterine inflammatory myofibroblastic tumor presented as abnormal uterine bleeding: Two cases report and literature review

Medicine (Baltimore). 2022 Dec 16;101(50):e32141. doi: 10.1097/MD.0000000000032141.

Abstract

Rationale: Inflammatory myofibroblastic tumor (IMT) is an extremely rare soft tissue neoplasm consisting of the proliferation of fibroblastic-myofibroblastic cells with inflammatory infiltrates. It is known to occur in many parts of the body and can generally present with benign or locally recurrent behavior. Anaplastic lymphoma kinase is a specific diagnostic marker for IMT, and approximately 50% of IMT patients have anaplastic lymphoma kinase gene rearrangements. Reports of the female genital tract are rare.

Patient concerns: Two patients (a 32-year-old multigravida and a 22-year-old nullipara) visited our clinic because of abnormal uterine bleeding and a uterine mass.

Diagnoses: Histopathological examination, immunohistochemical markers, and fluorescence in situ hybridization confirmed the presence of a rare uterine IMT.

Interventions: The masses were completely resected via hysteroscopy. The multigravida recurred rapidly in terms of symptoms and images, whereas the nullipara was complaint-free during the follow-up period. Finally, the multigravida underwent hysterectomy and bilateral salpingectomies.

Outcomes and lessons: Uterine IMTs can be easily overlooked because of their extremely low incidence rate and insufficient awareness among clinicians; however, uterine IMTs need to be considered in the differential diagnosis of uterine masses. Possible differences in the biological behavior of IMT may exist in different individuals.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adult
  • Anaplastic Lymphoma Kinase / genetics
  • Biomarkers, Tumor / genetics
  • Female
  • Granuloma, Plasma Cell* / pathology
  • Humans
  • In Situ Hybridization, Fluorescence
  • Neoplasm Recurrence, Local*
  • Pregnancy
  • Uterine Hemorrhage / etiology
  • Uterus / pathology
  • Young Adult

Substances

  • Anaplastic Lymphoma Kinase
  • Biomarkers, Tumor