Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Medicina (Kaunas). 2023 Apr 19;59(4):791. doi: 10.3390/medicina59040791.
Inflammatory myofibroblastic tumour (IMT) is a rare tumour with an intermediate biological behaviour. It usually occurs in children and adolescents, primarily in the abdomen or lungs. Histopathologically, IMT consists of spindle cells, i.e., myofibroblasts, and a variable inflammatory component. Localization in the urinary bladder is rare. We are presenting a rare case of IMT in the bladder in a middle-aged man treated by partial cystectomy. A 62-year-old man consulted a urologist because of haematuria and dysuric disturbances. A tumorous mass was detected by an ultrasound in the urinary bladder. CT urography described the tumorous mass at the dome of the urinary bladder measuring 2 × 5 cm. A smooth tumorous mass was cystoscopically observed at the dome of the urinary bladder. Transurethral resection of the bladder tumour was performed. Histopathological analysis of the specimen identified spindle cells with a mixed inflammatory infiltrate; immunohistochemical findings showed positivity for anaplastic lymphoma kinase (ALK), smooth muscle actin (SMA) and vimentin. A histopathological diagnosis of IMT was established. It was decided that the patient would undergo a partial cystectomy. A complete excision of the tumour from the dome of the urinary bladder with surrounding healthy tissue was performed. Histopathological and immunohistochemical findings of the sample confirmed the diagnosis of IMT, without the presence of the tumour at the surgical margins. The postoperative course went smoothly. IMT is a rare tumour in adults, especially localised in the urinary bladder. IMT of the urinary bladder is difficult to distinguish from urinary bladder malignancy both clinically and radiologically, as well as histopathologically. If the location and size of the tumour allow it, bladder-preserving surgeries such as partial cystectomy represent a reasonable modality of operative treatment.
炎性肌纤维母细胞瘤（IMT）是一种具有中间生物学行为的罕见肿瘤。它通常发生在儿童和青少年，主要发生在腹部或肺部。组织病理学上，IMT 由梭形细胞组成，即肌纤维母细胞，和一个可变的炎症成分。在膀胱中的定位很少见。我们报告了一例罕见的中年男性膀胱 IMT 病例，该患者接受了部分膀胱切除术。一名 62 岁男性因血尿和排尿障碍咨询泌尿科医生。超声检查发现膀胱内有一个肿瘤性肿块。CT 尿路造影描述了位于膀胱穹窿的肿瘤性肿块，大小为 2×5cm。膀胱镜下观察到膀胱穹窿处有一个光滑的肿瘤性肿块。行膀胱肿瘤经尿道电切术。标本的组织病理学分析确定了具有混合炎症浸润的梭形细胞；免疫组织化学结果显示间变性淋巴瘤激酶（ALK）、平滑肌肌动蛋白（SMA）和波形蛋白阳性。建立了 IMT 的组织病理学诊断。决定对患者进行部分膀胱切除术。从膀胱穹窿完整切除肿瘤及其周围的健康组织。样本的组织病理学和免疫组织化学检查结果证实了 IMT 的诊断，手术切缘无肿瘤。术后过程顺利。IMT 在成人中是一种罕见的肿瘤，特别是在膀胱局部。IMT 与膀胱癌在临床、影像学和组织病理学上都难以区分。如果肿瘤的位置和大小允许，部分膀胱切除术等保膀胱手术是一种合理的手术治疗方式。
