TY - JOUR
T1 - Inflammatory myofibroblastic tumor involving the central nervous system
AU - Bell, W. Robert
AU - Jusué-Torres, Ignacio
AU - Quiñones-Hinojosa, Alfredo
AU - Rodriguez, Fausto J.
PY - 2013/12/1
Y1 - 2013/12/1
N2 - Inflammatory myofibroblastic tumor (IMT) is a distinct mesenchymal neoplasm that arises in the lung, soft tissues and a variety of organs. In the past, morphologic and conceptual overlap with inflammatory pseudotumor, a presumed inflammatory lesion, has been described in the literature. However, demonstration of ALK gene rearrangements in a subset of cases supports the concept of a distinct neoplastic entity. In rare instances, it may involve the central nervous system, and present as a dural based mass mimicking meningioma. IMT has variable clinical behavior but may also behave in a malignant fashion in a proportion of cases. Interestingly, multicentricity has also been described with IMT. We discuss the case of a 30-year old woman who developed a well circumscribed intracranial mass interpreted preoperatively as a meningioma. Histologic examination demonstrated IMT containing an ALK rearrangement. The neoplasm was morphologically similar to a lung neoplasm resected 31 months previously. We use this case study as an opportunity to discuss the differential diagnosis of IMT with a focus on intrancranial locations and useful ancillary techniques in approaching the pathologic diagnosis.
AB - Inflammatory myofibroblastic tumor (IMT) is a distinct mesenchymal neoplasm that arises in the lung, soft tissues and a variety of organs. In the past, morphologic and conceptual overlap with inflammatory pseudotumor, a presumed inflammatory lesion, has been described in the literature. However, demonstration of ALK gene rearrangements in a subset of cases supports the concept of a distinct neoplastic entity. In rare instances, it may involve the central nervous system, and present as a dural based mass mimicking meningioma. IMT has variable clinical behavior but may also behave in a malignant fashion in a proportion of cases. Interestingly, multicentricity has also been described with IMT. We discuss the case of a 30-year old woman who developed a well circumscribed intracranial mass interpreted preoperatively as a meningioma. Histologic examination demonstrated IMT containing an ALK rearrangement. The neoplasm was morphologically similar to a lung neoplasm resected 31 months previously. We use this case study as an opportunity to discuss the differential diagnosis of IMT with a focus on intrancranial locations and useful ancillary techniques in approaching the pathologic diagnosis.
KW - ALK
KW - Inflammatory myofibroblastic tumor
KW - Inflammatory pseudotumor
KW - Meningioma
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U2 - 10.1097/PCR.0000000000000011
DO - 10.1097/PCR.0000000000000011
M3 - Article
AN - SCOPUS:84892758860
SN - 1082-9784
VL - 18
SP - 257
EP - 261
JO - Pathology Case Reviews
JF - Pathology Case Reviews
IS - 6
ER -