Diagnostic challenges and clinical management of inflammatory myofibroblastic tumor - a retrospective case series study

Sep 30, 2026

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Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm with diagnostic difficulty and scattered prior reports, particularly for uncommon primary sites. This retrospective case series describes six pathology-confirmed low-grade IMT patients (ages 15–63) undergoing surgery, with 13–33 months of follow-up. One nasal IMT recurred locally and one sacral IMT developed multiple distant bone metastases; the other four showed no recurrence or metastasis. Findings indicate that even low-grade IMT may behave aggressively, supporting comprehensive evaluation beyond pathology grading.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Case Description

Conclusions

Keywords

Diagnostic challenges and clinical management of inflammatory myofibroblastic tumor: a retrospective case series study Ling-Yu He1,2\#, Bo Chen3\#, Xiao Yu4, Sheng-Han Xu4,5, Cheng Zha4, Yue Li4, Sui-yang Jin4, Xue-Feng Peng4, Xin-Wen Wang6, Guo-Bing Li6, Qiang Wang4, Wei Li2 1Medical College of Soochow University, Suzhou, China; 2Department of Cardiovascular Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, China; 3Department of Urology, Baiyun Hospital Affiliated to Guizhou Medical University, Guiyang, China; 4Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China; 5Department of Urology, Liupanshui People’s Hospital, Liupanshui, China; 6Department of Urology, Guiyang Public Health Treatment Center, Guiyang, China Contributions: (I) Conception and design: LY He, B Chen, W Li, Q Wang; (II) Administrative support: None; (III) Provision of study materials or patients: LY He, B Chen, SH Xu, W Li, Q Wang; (IV) Collection and assembly of data: LY He, B Chen, X Yu, SH Xu, C Zha, Y Li, SY Jin, XF Peng, XW Wang, GB Li; (V) Data analysis and interpretation: LY He, B Chen, W Li, Q Wang; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. \#These authors contributed equally to this work as co-first authors. Correspondence to: Qiang Wang, PhD. Department of Urology, The Affiliated Hospital of Guizhou Medical University, No. 9 Beijing Road, Yunyan District, Guiyang 550004, [China. Email: gymnwq@163.com](China. Email: gymnwq@163.com); Wei Li, PhD. Department of Cardiovascular Medicine, The Affiliated Hospital of Guizhou Medical University, No. 9 Beijing Road, Yunyan District, Guiyang 550004, [China. Email: gyxnhly@126.com](China. Email: gyxnhly@126.com). Background: Inflammatory myofibroblastic tumor (IMT) is a relatively rare mesenchymal tumor in clinical practice and is difficult to diagnose. At present, clinical reports on this disease are still relatively scattered. Especially for IMT occurring in special sites such as the nasal cavity, sacrum, and bladder, systematic reports on its clinical manifestations, treatment responses, and prognostic characteristics are still lacking. Case Description: This study retrospectively reported six patients with low-grade IMT diagnosed by pathology (three males and three females), aged 15 to 63 years (with an average age of 41.67 years) . The maximum diameter of the tumors ranged from 2.0 to 9.5 cm (with an average of 4.4 cm), and the involved sites included the nasal cavity, upper limbs, chest wall, sacrum, and bladder. All patients underwent surgical treatment and were followed up for 13 to 33 months after the operation (with an average of 19.67 months) . Among them, one patient with nasal IMT had local recurrence after the operation, one patient with sacral IMT was found to have multiple bone metastases throughout the body during the follow-up period, and no recurrence or metastasis was observed in the remaining four cases. Conclusions: IMT is a tumor with “low malignant potential” or “borderline” characteristics. It is neither a typical benign tumor nor a highly malignant cancer, but occupies an intermediate gray zone. It can occur at multiple sites in the body, most commonly in the lungs, and has been reported across all age groups. Through the analysis of six cases of IMT with unusual primary sites, this study found that even with lowgrade pathological features, the tumor can still exhibit aggressive biological behavior, including postoperative recurrence and distant metastasis, when arising in atypical locations such as the sacrum or nasal cavity. This suggests that the clinical management of IMT should not rely solely on pathological grading but should also involve a comprehensive evaluation incorporating the tumor’s location and size. This case series contributes to broadening the understanding of the clinical spectrum of IMT, enhances awareness of IMT in rare sites, a

FAQs

Why is inflammatory myofibroblastic tumor (IMT) difficult to diagnose?

IMT is described as a relatively rare mesenchymal tumor in clinical practice and is difficult to diagnose. Existing reports are also relatively scattered, which limits evidence for diagnosis across sites.

What outcomes were observed after surgical treatment in the six patients?

All six patients underwent surgery and were followed for 13–33 months. One patient with nasal IMT had local recurrence, and one patient with sacral IMT developed multiple bone metastases; the other four showed neither recurrence nor metastasis.

Does low-grade pathology guarantee a benign course in IMT?

No. The study concludes that even with low-grade pathological features, IMT can show aggressive biological behavior, including postoperative recurrence and distant metastasis, especially in atypical locations.

Sep 30, 2026

Uploaded by Rhys