Pannain VL, Passos JV, Filho ADR, Villela-Nogueira C, Caroli-Bottino A. Agressive inflammatory myofibroblastic tumor of the liver with underlying schistosomiasis: A case report. World J Gastroenterol 2010; 16(33): 4233-4236 [PMID: 20806444 DOI: 10.3748/wjg.v16.i33.4233]
Corresponding Author of This Article
Vera Lucia Pannain, MD, PhD, Department of Pathology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, 255, Rodolpho Paulo Rocco Av, 21941-590, Rio de Janeiro, Brazil. verapannain@hotmail.com
Article-Type of This Article
Case Report
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Case Report
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World J Gastroenterol. Sep 7, 2010; 16(33): 4233-4236 Published online Sep 7, 2010. doi: 10.3748/wjg.v16.i33.4233
Agressive inflammatory myofibroblastic tumor of the liver with underlying schistosomiasis: A case report
Vera Lucia Pannain, Juliana Vial Passos, Ariovaldo da Rocha Filho, Cristiane Villela-Nogueira, Adriana Caroli-Bottino
Vera Lucia Pannain, Juliana Vial Passos, Ariovaldo da Rocha Filho, Adriana Caroli-Bottino, Department of Pathology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, 21941-590, Rio de Janeiro, Brazil
Cristiane Villela-Nogueira, Department of Internal Medicine, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, 21941-590, Rio de Janeiro, Brazil
Author contributions: Pannain VL carried out and reviewed the pathological diagnosis, designed and wrote the manuscript; Passos JV and Rocha Filho A reviewed the literature and reported the case; Villela-Nogueira C reviewed the manuscript; Caroli-Bottino A carried out and reviewed the pathological diagnosis.
Correspondence to: Vera Lucia Pannain, MD, PhD, Department of Pathology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, 255, Rodolpho Paulo Rocco Av, 21941-590, Rio de Janeiro, Brazil. verapannain@hotmail.com
Telephone: +55-21-25622283 Fax: +55-21-25622283
Received: May 14, 2010 Revised: June 4, 2010 Accepted: June 11, 2010 Published online: September 7, 2010
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.
