Su Zhen-Jin, Guo Ze-Shang, Wan Heng-Tong, Hong Xin-Yu
Department of Neurosurgical Oncology, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China.
World J Clin Cases. 2022 Dec 6;10(34):12637-12647. doi: 10.12998/wjcc.v10.i34.12637.
An inflammatory myofibroblastic tumor (IMT) occurring in the central nervous system is very rare, and thus its pathogenesis is unknown. This case report and literature review aimed to explore the pathogenesis, clinical features, imaging findings, pathological characteristics, immunohistochemical characteristics, diagnoses, treatments, and risks of postoperative recurrence of IMT in the central nervous system.
A 67-year-old woman was admitted to the hospital with an exophthalmic protrusion and double vision in the left eye that had persisted for 3 mo. Magnetic resonance imaging (MRI) showed a 2.4 cm × 1.3 cm heterogeneous large mass in the bottom of the left anterior cranial fossa, which was closely related to the dura mater. Before surgery, we suspected the mass to be meningioma. The entire mass was successfully removed under neuronavigation and electrophysiological monitoring, and postoperative pathology indicated an IMT with extensive infiltration of chronic inflammatory cells and scattered multinucleated giant cells. Head MRI at the 3-mo follow-up showed that the tumor at the bottom of left anterior cranial fossa had been completely resected without recurrence.
From the histological, immunohistochemical, and genetic analyses, the present case suggests that the pathogenesis of IMT-CNS is related to autoimmunity.
发生于中枢神经系统的炎性肌纤维母细胞瘤（IMT）非常罕见，因此其发病机制尚不清楚。本病例报告及文献综述旨在探讨中枢神经系统IMT的发病机制、临床特征、影像学表现、病理特征、免疫组化特征、诊断、治疗及术后复发风险。
一名67岁女性因左眼眼球突出和复视持续3个月入院。磁共振成像（MRI）显示左前颅窝底部有一个2.4 cm×1.3 cm的异质性大肿块，与硬脑膜关系密切。术前，我们怀疑该肿块为脑膜瘤。在神经导航和电生理监测下成功切除了整个肿块，术后病理显示为IMT，有大量慢性炎性细胞浸润和散在的多核巨细胞。术后3个月的头部MRI显示左前颅窝底部的肿瘤已完全切除，无复发。
从组织学、免疫组化和基因分析来看，本病例提示中枢神经系统IMT的发病机制与自身免疫有关。
