Filips A, Maurer MH, Montani M, Beldi G, Lachenmayer A. Inflammatory myofibroblastic tumor of the liver: A case report and review of literature. World J Hepatol 2020; 12(4): 170-183 [PMID: 32685109 DOI: 10.4254/wjh.v12.i4.170]
Corresponding Author of This Article
Anja Lachenmayer, MD, PhD, Doctor, Surgeon, Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, Bern 3010, Switzerland. anja.lachenmayer@insel.ch
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Apr 27, 2020; 12(4): 170-183 Published online Apr 27, 2020. doi: 10.4254/wjh.v12.i4.170
Inflammatory myofibroblastic tumor of the liver: A case report and review of literature
Alexandra Filips, Martin H Maurer, Matteo Montani, Guido Beldi, Anja Lachenmayer
Alexandra Filips, Guido Beldi, Anja Lachenmayer, Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
Martin H Maurer, Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
Matteo Montani, Institute of Pathology, Inselspital, University Hospital, University Bern, Bern 3010, Switzerland
Author contributions: Filips A reviewed the literature and contributed to manuscript drafting; Filips A, Maurer MH, Montani M, Beldi G and Lachenmayer A were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Anja Lachenmayer, MD, PhD, Doctor, Surgeon, Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, Bern 3010, Switzerland. anja.lachenmayer@insel.ch
Received: November 29, 2019 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 Processing time: 145 Days and 20.6 Hours
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
