Division of General Surgery, Department of Surgery, Groote Schuur Hospital, University of Cape Town, South Africa.
University of Chicago Centre for Global Health, United States of America.
S Afr J Surg. 2024 May;62(2):23-27.
Hepatic inflammatory myofibroblastic tumours (HIMTs) are rare and poorly described in the literature. Most publications are single patient case reports and lack detailed reporting on characteristics, management, and outcomes. This systematic review aimed to assess the demography, clinical presentation, typical imaging features, histopathology, treatment, and outcomes of patients presenting with HIMTs.
A systematic literature search was performed in MEDLINE (PubMed), EMBASE (Scopus), JSTOR, Cochrane CENTRAL (Cochrane Library), and the databases included in the Web of Science for studies published between 1940 and 2023 on HIMTs, including its reported synonyms. Case series or cohort studies that reported on the management and outcomes of at least four patients with histologically confirmed HIMTs were included in the analysis.
After screening 4553 publications, 22 articles including a total of 440 patients with confirmed HIMTs were eligible for inclusion. The average age was 53.4 years (range 42.0-65.0) with a male to female ratio of 1.7:1. Abdominal pain, discomfort, fever, and loss of weight were the most common presenting symptoms. Surgical resection is the standard of care for HIMTs and is associated with low mortality of 3.4% and low disease recurrence.
HIMT is a disease more often affecting middle-aged males. The lesions are typically solitary with low recurrence after treatment. The relative roles of surgical versus medical treatment remain unclear. Differences in clinical presentation, histopathology, and treatment of HIMTs compared to inflammatory myofibroblastic tumour (IMT) at extrahepatic sites could challenge the current view of IMT as a single pathological entity.
肝炎性肌纤维母细胞瘤（HIMTs）在文献中较为罕见且描述不足。大多数出版物为单一患者病例报告，缺乏对特征、管理和结果的详细报告。本系统评价旨在评估表现为 HIMTs 的患者的人口统计学、临床表现、典型影像学特征、组织病理学、治疗和结局。
在 MEDLINE（PubMed）、EMBASE（Scopus）、JSTOR、Cochrane CENTRAL（Cochrane 图书馆）以及 Web of Science 中包含的数据库中进行了系统文献检索，检索时间为 1940 年至 2023 年，检索内容为关于 HIMTs 及其报告的同义词的研究。包括至少 4 例经组织学证实的 HIMTs 患者的管理和结局的病例系列或队列研究被纳入分析。
在筛选了 4553 篇文献后，有 22 篇文章符合纳入标准，共纳入 440 例经组织学证实的 HIMTs 患者。平均年龄为 53.4 岁（范围为 42.0-65.0），男女比例为 1.7:1。腹痛、不适、发热和体重减轻是最常见的首发症状。手术切除是 HIMTs 的标准治疗方法，其死亡率为 3.4%，疾病复发率低。
HIMT 是一种更常发生于中年男性的疾病。病变通常为单发，治疗后复发率低。手术治疗与药物治疗的相对作用仍不清楚。与肝外部位的炎性肌纤维母细胞瘤（IMT）相比，HIMTs 在临床表现、组织病理学和治疗方面的差异可能挑战当前将 IMT 视为单一病理实体的观点。
