Beauchamp Ana, Villanueva Adolfo, Feliciano Walter, Reymunde Alvaro
From the Medical Faculty Hospital Damas, Ponce, Puerto Rico.
Bol Asoc Med P R. 2011 Apr-Jun;103(2):60-4.
Inflammatory myofibroblastic tumor (IMT) is a rare benign lesion of unknown etiology reported in numerous anatomic sites. Hepatic IMT is rare. It is composed of a dominant spindle cell proliferation with a variable inflammatory component that has unique histological appearance. The tumor is more common in women, who often present with fever of unknown origin or other vague, nonspecific symptoms. A 74-year-old female presented with fever of unknown origin. Abdominal CT-Scan showed focal mass effect with luminal narrowing at the distal sigmoid colon, highly suggestive of a sigmoid neoplasm as well as numerous hypodense lesions scattered throughout the liver, likely representing metastatic disease. Liver biopsy revealed an IMT. Patient was treated conservatively and remained without symptoms. It is extremely difficult to differentiate an IMT from neoplastic disease. Most cases require complete resection to obtain an accurate diagnosis. This entity should be considered in the differential diagnosis in patients with hepatic lesions to avoid unnecessary surgical procedures.
炎性肌成纤维细胞瘤（IMT）是一种病因不明的罕见良性病变，在众多解剖部位均有报道。肝脏IMT较为罕见。它由占主导的梭形细胞增殖以及具有独特组织学表现的可变炎症成分组成。该肿瘤在女性中更为常见，她们常表现为不明原因发热或其他模糊、非特异性症状。一名74岁女性出现不明原因发热。腹部CT扫描显示乙状结肠远端有局灶性肿块效应及管腔狭窄，高度提示乙状结肠肿瘤，同时肝脏内散在多个低密度病变，可能代表转移性疾病。肝脏活检显示为IMT。患者接受了保守治疗，且无症状。将IMT与肿瘤性疾病区分开来极其困难。大多数病例需要完整切除才能获得准确诊断。在肝病变患者的鉴别诊断中应考虑到这一实体，以避免不必要的外科手术。
