Inflammatory Myofibroblast Tumor of the Liver after Bone Marrow Transplantation: Case Report and Literature Review

Yang Shuhui ^* Tang Yongsheng Zhang Jianwen Yuan Zenan

• Department of Hepatic Surgery and Liver Transplantation Center, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

Inflammatory myofibroblast tumor (IMT) is a rare low-grade malignant tumor in the liver.Owing to its atypical symptoms and radiographic manifestations, we often misdiagnose it. Here, we report a 46-year-old female who was examined in our hospital for pyrexia and right upper quadrant abdominal pain. Radiographic examination revealed a space-occupying lesion of indeterminate nature in her liver. In light of her antecedent history of leukemia, leukemic hepatic infiltration was suspected, and a percutaneous hepatic biopsy was subsequently conducted. The histological examination of the biopsy specimen was indicative of IMT. A laparoscopic anatomic resection was elected. Postoperatively, the patient's febrile condition remitted. At the 8-month follow-up, magnetic resonance (MR) imaging demonstrated an absence of recurrence. Immunosuppression and infection may be related to IMT. It requires pathology to confirm the diagnosis. The recommended treatment for local IMT is still surgical radical resection. When distant metastasis occurs or surgery cannot completely remove the tumor, we can choose comprehensive treatment. Introduction: Inflammatory myofibroblast tumor (IMT) is a rare low -grade malignant neoplasm in the liver. It makes prompt diagnosis and treatment difficult due to its atypical symptoms and imaging results.Case report: We report a 46-year-old female who presented to our hospital due to complaining persistent hyperpyrexia and right upper abdomen discomfort for two months post after bone marrow transplantation. The radiological findings revealed a space occupying lesion of uncertain nature in the liver. Since the biopsy specimen's histological examination indicated IMT, she underwent surgical resection. Subsequently, the postoperative pathology confirmed the diagnosis of IMT. The patient's febrile condition subsided postoperatively. Magnetic resonance imaging (MRI) showed no recurrence eight months later.IMT is caused by genetic rearrangements. It was difficult to diagnose IMT in this case as we had to differentiate IMT from inflammatory disease in the background of bone marrow transplantation. Hence, pathological immunohistochemical examination is required to confirm its diagnosis. Local IMTs should be treated with radical surgical resection. In distant metastasis or incomplete resection cases, chemotherapy, targeted therapy, or immunotherapy can be utilized.Regular follow up is crucial for improving the patient's survival rate.