Balagobi Balasingam, Gobishangar Sreekanthan, Ginige Anusha, Gamlaksha Dayal, Sanjeyan Jeyarajah, Suvethini Loganathan
Professorial Surgical Department, Teaching Hospital Jaffna.
District General Hospital, Vavuniya, Sri Lanka.
Int J Surg Case Rep. 2022 Mar;92:106786. doi: 10.1016/j.ijscr.2022.106786. Epub 2022 Jan 24.
Inflammatory myofibroblastic tumour (IMT) is a rare tumour with malignant potential and has been described in many major organs with the most frequent site being the lungs. However, bladder is an extremely rare location. IMT presents a unique diagnostic challenge because of the characteristics it shares with malignant neoplasms.
Here we report the case of a 47-yearold male who presented with storage lower urinary tract symptoms associated with non-specific lower abdominal pain for one month duration. Contrast-enhanced computed tomography of abdomen and pelvis revealed a 6 cm tumour at the dome and left side anterior wall of the bladder. He underwent laparotomy and partial cystectomy. Histopathology results were consistent with an IMT.
Even though bladder IMT is indolent in course, typical IMTs can be locally aggressive. Due to the lack of specificity in clinical symptoms, it is not easy to arrive at a precise diagnosis before surgery. Hence, the final diagnosis depends on histomorphological features and the immune histochemical profile.
It can be challenging to distinguish IMT from malignant neoplasms both clinically and histologically. As such, local surgical resection with close follow-up remains the mainstay of treatment for urinary tract IMT.
炎性肌纤维母细胞瘤（IMT）是一种具有恶性潜能的罕见肿瘤，已在许多主要器官中被描述，最常见的部位是肺部。然而，膀胱是极为罕见的发病部位。由于IMT与恶性肿瘤有共同特征，因此在诊断上具有独特的挑战性。
我们在此报告一例47岁男性患者，其出现下尿路储尿期症状并伴有非特异性下腹部疼痛，持续了一个月。腹部和盆腔增强CT显示膀胱顶部和左侧前壁有一个6厘米的肿瘤。他接受了剖腹手术和部分膀胱切除术。组织病理学结果与IMT一致。
尽管膀胱IMT病程进展缓慢，但典型的IMT可能具有局部侵袭性。由于临床症状缺乏特异性，术前难以做出准确诊断。因此，最终诊断取决于组织形态学特征和免疫组织化学特征。
在临床和组织学上，将IMT与恶性肿瘤区分开来具有挑战性。因此，局部手术切除并密切随访仍是尿路IMT的主要治疗方法。
