Department of Obstetrics and Gynecology, Affiliated Hospital of Weifang Medical University, Weifang, Shandong, China (mainland).
Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China (mainland).
Am J Case Rep. 2023 Nov 13;24:e941519. doi: 10.12659/AJCR.941519.
BACKGROUND Inflammatory myofibroblastic tumor (IMT) is a rare disease, and uterine IMT is even rarer. IMT is hard to distinguish from endometrial polyp and submucous myoma. The treatment of IMT is still controversial. Here, we report a case of uterine IMT, discussing both pathological and therapeutic aspects. CASE REPORT A 32-year-old woman was admitted to our hospital for a uterine mass, hypermenorrhea, and anemia. She had been suffering from these symptoms for almost a year. Pelvic ultrasound and MRI revealed a mass about 7 cm in diameter at the bottom of the uterus. Serum tumor markers were negative. She was diagnosed with submucous fibroids of the uterus. Then she underwent hysteroscopic mass resection. Histopathological and immunohistochemistry stain analysis revealed IMT of the uterus. Due to the malignant potential of IMT, she was advised to undergo a total hysterectomy, but she refused because she wanted to retain the uterus and fertility. A watch-and-wait strategy without any therapy was chosen, and the patient is currently disease-free after 18-month follow-up. CONCLUSIONS IMT is a disease with malignant potential and may recur at a late stage; hence, a correct diagnosis is essential for patients with IMT. Surgery is the preferred treatment for IMT. For early-stage, young women who want to preserve fertility, conservative surgery is acceptable, but close follow-up is required to avoid recurrence and metastasis. If a patient cannot undergo surgery or the disease has metastasized extensively, targeted therapy for ALK gene, immunotherapy, and other methods can be considered.
炎性肌纤维母细胞瘤（IMT）是一种罕见疾病，而子宫 IMT 更为罕见。IMT 很难与子宫内膜息肉和黏膜下肌瘤相区分。IMT 的治疗仍存在争议。在此，我们报告一例子宫 IMT 病例，讨论其病理和治疗方面。
一名 32 岁女性因子宫肿块、月经过多和贫血就诊。她已出现这些症状近一年。盆腔超声和 MRI 显示子宫底部有一个约 7cm 直径的肿块。血清肿瘤标志物阴性。她被诊断为子宫黏膜下肌瘤。随后她接受了宫腔镜下肿块切除术。组织病理学和免疫组织化学染色分析显示为子宫 IMT。由于 IMT 具有恶性潜能，建议她行全子宫切除术，但她拒绝了，因为她希望保留子宫和生育能力。选择了观察等待策略而不进行任何治疗，患者在 18 个月的随访后目前无疾病。
IMT 是一种具有恶性潜能的疾病，可能在晚期复发；因此，正确的诊断对 IMT 患者至关重要。手术是 IMT 的首选治疗方法。对于早期、希望保留生育能力的年轻女性，可接受保留生育能力的保守手术，但需要密切随访以避免复发和转移。如果患者不能接受手术或疾病已广泛转移，可以考虑针对 ALK 基因的靶向治疗、免疫治疗等方法。
