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Agressive inflammatory myofibroblastic tumor of the liver with underlying schistosomiasis: a case report.

Authors
  • Pannain, Vera Lucia
  • Passos, Juliana Vial
  • Rocha Filho, Ariovaldo
  • Villela-Nogueira, Cristiane
  • Caroli-Bottino, Adriana
Type
Published Article
Journal
World Journal of Gastroenterology
Publisher
Baishideng Publishing Group Co
Publication Date
Sep 07, 2010
Volume
16
Issue
33
Pages
4233–4236
Identifiers
PMID: 20806444
Source
Medline
License
Unknown

Abstract

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.

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