Published online Apr 27, 2020. doi: 10.4254/wjh.v12.i4.170
Peer-review started: November 29, 2019
First decision: December 12, 2019
Revised: February 14, 2020
Accepted: March 11, 2020
Article in press: March 11, 2020
Published online: April 27, 2020
Inflammatory myofibroblastic tumors of the liver (IMTL) are extremely rare neoplasms and very little is known about their clinical presentation, pathogenesis, and biological behavior. Due to their absolute rarity, it is almost impossible to obtain a definite diagnosis without histological examination. Because of their intermediate biological behavior with the risk for local recurrence and metastases, surgical resection is recommend whenever IMTL is suspect.
We herein present a case of an otherwise healthy 32-year-old woman who presented with intermittent fever, unclear anemia, malaise and right flank pain 4 mo postpartum. The liver mass in segment IVa/b was highly FDG avid in the positron emission tomography-computed tomography. Hepatic resection was performed achieving a negative resection margin and an immediate resolution of all clinical symptoms. Histological analysis diagnosed the rare finding of an inflammatory myofibroblastic tumor of the liver and revealed cytoplasmic anaplastic lymphoma kinase expression by immunohistochemistry. Twelve months follow-up magnetic resonance imaging showed no recurrence and no metastases in the fully recovered patient.
IMTLs are extremely rare and difficult to diagnose. Due to their intermediate biological behavior, surgical resection should be perform whenever feasible and patients should be followed-up in order to detect recurrence and metastasis as early as possible.
Core tip: In summary of the literature and with the experience from our own recent case, complete surgical resection of suspected inflammatory myofibroblastic tumors of the liver should be the preferred treatment of choice in order to rule out malignancy, avoid long-term medical treatment and to be able to recommend an appropriate follow-up for the patient.