Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Childs Nerv Syst. 2024 Nov 30;41(1):24. doi: 10.1007/s00381-024-06690-4.
Inflammatory myofibroblastic tumor (IMT) is a rare, benign lesion of uncertain etiology, predominantly affecting soft tissues such as the lungs, with spinal involvement being exceedingly rare. We present the case of a 10-year-old male with a year-long history of low back pain, constipation, and difficulty in urination. MRI revealed an intradural extramedullary lesion at L5-S1, initially suspected to be a schwannoma or neurofibroma. The patient underwent L5 laminectomy and near-total excision of the tumor. Histopathological examination confirmed IMT, characterized by spindle cells and dense inflammatory infiltration. At 18 months follow-up, MRI showed no tumor progression with complete clinical improvement. This is the first reported case of IMT in pediatric age, affecting the lumbosacral spine. It highlights the importance of considering IMT in the differential diagnosis of spinal tumors, particularly when multiple nerve roots are involved, with intraoperative findings of an inflammatory lesion. Surgery remains the definitive treatment.
炎性肌纤维母细胞瘤（IMT）是一种罕见的、病因不明的良性病变，主要影响肺部等软组织，脊柱受累极为罕见。我们报告了一例 10 岁男性患者，其病史长达 1 年，表现为腰痛、便秘和排尿困难。MRI 显示 L5-S1 椎管内硬膜外病变，最初怀疑为神经鞘瘤或神经纤维瘤。患者接受了 L5 椎板切除术和肿瘤近全切除术。组织病理学检查证实为 IMT，其特征为梭形细胞和密集的炎症浸润。18 个月随访时，MRI 显示无肿瘤进展，临床症状完全改善。这是首例发生于儿童、累及腰骶脊柱的 IMT 病例。它强调了在鉴别诊断脊柱肿瘤时应考虑 IMT 的重要性，特别是当多个神经根受累，术中发现为炎症性病变时。手术仍然是明确的治疗方法。
