Skip to main content
Log in

Imaging of childhood inflammatory myofibroblastic tumor

  • Original Article
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Background

Inflammatory myofibroblastic tumor is a rare benign neoplasm and most commonly involves the lung but occurs in extrapulmonary locations.

Objective

To present imaging findings in inflammatory myofibroblastic tumors in children based on a single-centre experience.

Materials and methods

We retrospectively reviewed CT and MRI findings of children diagnosed with inflammatory myofibroblastic tumor in a single institution.

Results

We identified 15 children (range: 1–17 years) with inflammatory myofibroblastic tumor. The tumor was localized to the lung (n = 5), mediastinum (n = 3), trachea (n = 1), bronchus (n = 1), abdomen (n = 2) and orbit (n = 3). All the extraorbital tumors were solid masses with homogeneous or heterogeneous enhancement. Four lung tumors and one posterior mediastinal tumor contained calcification. Local recurrence following surgical removal occurred in two children with invasion of the esophagus and of the left atrium in one. Localized masses were seen in all children with orbital tumour. Two of these had episcleritis and perineuritis; one had episcleritis, tendonitis, perineuritis, myositis and dacryoadenitis.

Conclusion

The locations and imaging features of inflammatory myofibroblastic tumors are variable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Hedlund GL, Navoy JF, Galliani CA et al (1999) Aggressive manifestations of inflammatory pulmonary pseudotumor in children. Pediatr Radiol 29:112–116

    Article  CAS  PubMed  Google Scholar 

  2. Patankar T, Prasad S, Shenoy A et al (2000) Pulmonary inflammatory pseudotumor in children. Australas Radiol 44:318–320

    Article  CAS  PubMed  Google Scholar 

  3. Karnak I, Senocak ME, Ciftci AO et al (2001) Inflammatory myofibroblastic tumor in children: diagnosis and treatment. J Pediatr Surg 36:908–912

    Article  CAS  PubMed  Google Scholar 

  4. Patnana M, Sevrukov AB, Elsayes KM et al (2012) Inflammatory pseudotumor: the great mimicker. AJR Am J Roentgenol 198:W217–W227

    Article  PubMed  Google Scholar 

  5. Narla LD, Newman B, Spottswood SS et al (2003) Inflammatory pseudotumor. Radiographics 23:719–729

    Article  PubMed  Google Scholar 

  6. Kim SJ, Kim WS, Cheon JE et al (2009) Inflammatory myofibroblastic tumors of the abdomen as mimickers of malignancy: imaging features in nine children. AJR Am J Roentgenol 193:1419–1424

    Article  PubMed  Google Scholar 

  7. Choi BY, Kim WS, Cheon JE et al (2003) Inflammatory myofibroblastic tumour of the liver in a child: CT and MR findings. Pediatr Radiol 33:30–33

    Article  PubMed  Google Scholar 

  8. Day DL, Sane S, Dehner LP (1986) Inflammatory pseudotumor of the mesentery and small intestine. Pediatr Radiol 16:210–215

    Article  CAS  PubMed  Google Scholar 

  9. Taratuta E, Krinsky G, Genega E et al (1996) Pediatric inflammatory pseudotumor of the stomach: contrast-enhanced CT and MR imaging findings. AJR Am J Roentgenol 167:919–920

    Article  CAS  PubMed  Google Scholar 

  10. Sanders BM, West KW, Gingalewski C et al (2001) Inflammatory pseudotumor of the alimentary tract: clinical and surgical experience. J Pediatr Surg 36:169–173

    Article  CAS  PubMed  Google Scholar 

  11. Park SB, Cho KS, Kim JK et al (2008) Inflammatory pseudotumor (myoblastic tumor) of the genitourinary tract. AJR Am J Roentgenol 191:1255–1262

    Article  PubMed  Google Scholar 

  12. Brunn H (1939) Two interesting benign lung tumours of contradictory histopathology: remarks on the necessity for maintaining the chest tumour registry. J Thorac Cardiovasc 9:119–131

    Google Scholar 

  13. Umiker WO, Iverson LC (1954) Post inflammatory tumor of the lung: report of four cases simulating xanthoma, fibroma or plasma cell granuloma. J Thorac Surg 28:55–62

    CAS  PubMed  Google Scholar 

  14. Kirkpatrick JA Jr, Harris GB, Kushner DC (1984) Thoracic complications of plasma cell granuloma of the lung. Ann Radiol 27:145–149

    PubMed  Google Scholar 

  15. Cook JR, Dehner LP, Collins MH et al (2001) Anaplastic lymphoma kinase (ALK) expression in the inflammatory myofibroblastic tumor: a comparative immunohistochemical study. Am J Surg Pathol 25:1364–1368

    Article  CAS  PubMed  Google Scholar 

  16. Lawrence B, Perez-Atayde A, Hibbard MK et al (2000) TPM3-ALK and TPM4-ALK oncogenes in inflammatory myofibroblastic tumors. Am J Pathol 157:377–384

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Priebe-Richter C, Ivanyi P, Buer J et al (2005) Inflammatory pseudotumor of the lung following invasive aspergillosis in a patient with chronic graft-vs.-host disease. Eur J Haematol 75:68–72

    Article  PubMed  Google Scholar 

  18. Takayama Y, Yabuuchi H, Matsuo Y et al (2008) Computed tomographic and magnetic resonance features of inflammatory myofibroblastic tumor of the lung in children. Radiat Med 26:613–617

    Article  PubMed  Google Scholar 

  19. Yan FH, Zhou KR, Jiang YP et al (2001) Inflammatory pseudotumor of the liver: 13 cases of MRI findings. World J Gastroenterol 7:422–424

    CAS  PubMed  Google Scholar 

  20. McCarville MB, Hoffer FA, Adelman S et al (2007) MRI and biological behavior of desmoid tumors in children. AJR Am J Roentgenol 189:633–640

    Article  PubMed  Google Scholar 

  21. Huellner MW, Schwizer B, Burger I et al (2010) Inflammatory pseudotumor of the lung with high FDG uptake. Clin Nucl Med 35:722–723

    Article  PubMed  Google Scholar 

  22. Alongi F, Bolognesi A, Gajate AM et al (2010) Inflammatory pseudotumor of mediastinum treated with tomotherapy and monitored with FDG-PET/CT: case report and literature review. Tumori 96:322–326

    PubMed  Google Scholar 

  23. Athanassiadi K, Laenger F, Dickgreber N et al (2009) Multiple inflammatory myofibroblastic tumors involving lung and mediastinum: a rare clinical entity. Thorac Cardiov Surg 57:343–346

    Article  CAS  Google Scholar 

  24. Corneli G, Alifano M, Forti Parri S et al (2001) Invasive inflammatory pseudotumor involving the lung and mediastinum. Thorac Cardiovasc Surg 49:124–126

    Article  CAS  PubMed  Google Scholar 

  25. Li L, Burke A, He J et al (2011) Sudden unexpected death due to inflammatory myofibroblastic tumor of the heart: a case report and review of the literature. Int J Legal Med 125:81–85

    Article  PubMed  Google Scholar 

  26. Sugiyama K, Nakajima Y (2008) Inflammatory myofibroblastic tumor in the mediastinum mimicking a malignant tumor. Diagn Interv Radiol 14:197–199

    PubMed  Google Scholar 

  27. Guan Y, Chen G, Zhang W et al (2012) Computed tomography appearance of inflammatory myofibroblastic tumor in the mediastinum. J Comput Assist Tomogr 36:654–658

    Article  PubMed  Google Scholar 

  28. Dhouib A, Barrazzone C, Reverdin A et al (2013) Inflammatory myofibroblastic tumor of the lung: a rare cause of atelectasis in children. Pediatr Radiol 43:381–384

    Article  PubMed  Google Scholar 

  29. De Palma A, Loizzi D, Sollitto F et al (2009) Surgical treatment of a rare case of tracheal inflammatory pseudotumor in pediatric age. Interact Cardiovasc Thorac Surg 9:1035–1037

    Article  PubMed  Google Scholar 

  30. Franquet T, Montes M, Aizcorbe M et al (1989) Inflammatory pseudotumor of the spleen: ultrasound and computed tomographic findings. Gastrointest Radiol 14:181–183

    Article  CAS  PubMed  Google Scholar 

  31. Tublin ME, Moser AJ, Marsh JW et al (2007) Biliary inflammatory pseudotumor: imaging features in seven patients. AJR Am J Roentgenol 188:W44–W48

    Article  PubMed  Google Scholar 

  32. Uysal S, Tuncbilek I, Unlubay D et al (2005) Inflammatory pseudotumor of the sigmoid colon mesentery: US and CT findings. Eur Radiol 15:633–635

    Article  PubMed  Google Scholar 

  33. Slavotinek JP, Bourne AJ, Sage MR et al (2000) Inflammatory pseudotumor of the pancreas in a child. Pediatr Radiol 30:801–803

    Article  CAS  PubMed  Google Scholar 

  34. Lee HJ, Kim JS, Choi YS et al (2007) Treatment of inflammatory myofibroblastic tumor of the chest: the extent of resection. Ann Thorac Surg 84:221–224

    Article  PubMed  Google Scholar 

  35. Melloni G, Caretta A, Ciriaco P et al (2005) Inflammatory pseudotumor of the lung in adults. Ann Thorac Surg 79:426–432

    Article  PubMed  Google Scholar 

  36. Belanger C, Zhang KS, Reddy AK et al (2010) Inflammatory disorders of the orbit in childhood: a case series. Am J Ophthalmol 150:460–463

    Article  PubMed  Google Scholar 

  37. Weber AL, Romo LV, Sabates NR (1999) Pseudotumor of the orbit: clinical, pathologic, and radiologic evaluation. Radiol Clin North Am 37:151–168

    Article  CAS  PubMed  Google Scholar 

  38. Mendenhall WM, Lessner AM (2010) Orbital pseudotumor. Am J Clin Oncol 33:304–306

    Article  PubMed  Google Scholar 

  39. Martin CJ (1997) Orbital pseudotumor: a case report and overview. J Am Optom Assoc 68:775–781

    CAS  PubMed  Google Scholar 

  40. Sepahdari AR, Aakalu VK, Setabutr P et al (2010) Indeterminate orbital masses: restricted diffusion at MR imaging with echo-planar diffusion-weighted imaging predicts malignancy. Radiology 256:554–564

    Article  PubMed  Google Scholar 

  41. Mombaerts J, Sachlingermann RO, Koorneef L (1996) Are systemic corticosteroids useful in the management of orbital pseudotumors. Ophthalmology 103:521–528

    Article  CAS  PubMed  Google Scholar 

  42. Cherukupally SR, Mankarious LA, Fraquin W et al (2003) Pediatric non-orbital pseudotumor of the head and neck. Int J Pediatr Otorhinolaryngol 67:649–653

    Article  PubMed  Google Scholar 

  43. Park SB, Lee JH, Weon YC (2009) Imaging findings of head and neck inflammatory pseudotumor. AJR Am J Roentgenol 193:1180–1186

    Article  PubMed  Google Scholar 

  44. Horska A, Barker PB (2010) Imaging of brain tumors: MR spectroscopy and metabolic imaging. Neuroimaging Clin N Am 20:293–310

    Article  PubMed Central  PubMed  Google Scholar 

  45. Weber MA, Wiehoever A, Stieltjes B et al (2005) Intracerebral manifestation of an atypical monoclonal plasma cell hyperplasia depicted by MR perfusion and diffusion tensor imaging and MR spectroscopy. AJR Am J Roentgenol 185:784–787

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Berna Oguz.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Oguz, B., Ozcan, H.N., Omay, B. et al. Imaging of childhood inflammatory myofibroblastic tumor. Pediatr Radiol 45, 1672–1681 (2015). https://doi.org/10.1007/s00247-015-3377-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-015-3377-x

Keywords

Navigation