Download PDF
CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0043-1777041
Case Report with Review of Literature

Renal Inflammatory Myofibroblastic Tumor in an Infant: Case Report with Review of Literature

Vinayak Dave 
1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Aekta Shah 
1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Badira Parambil
2   Department of Pediatric Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Poonam Panjwani
1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Sajid Qureshi
3   Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Mukta Ramadwar
1   Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
› Author Affiliations Financial Support and Sponsorship None.
› Further Information
   Permissions and Reprints

Abstract

Inflammatory myofibroblastic tumor (IMT) is an intermediate-grade neoplasm of myofibroblastic lineage occurring due to a cytogenetic clonal abnormality of chromosome 2p23. Pediatric renal IMTs are rare and infant renal IMTs are almost anecdotal. We herein report a 1-year-old female child who presented with a firm mass in the right lumbar region. Biopsy, and later, surgical resection revealed a tumor composed of spindle cells with intermixed plasma cells. On immunohistochemistry (IHC), the lesional cells were positive for smooth muscle actin and anaplastic lymphoma kinase (ALK). A diagnosis of IMT was made based on morphology and IHC. Diagnosis of renal IMTs become challenging especially in a tiny biopsy wherein clear cell sarcoma of kidney, Wilms tumor with predominant mesenchymal component, congenital mesoblastic nephroma, and metanephric stromal tumor are the differential diagnoses in this age group. Renal IMTs generally have better prognosis as compared to extrarenal IMTs. Approximately, 50 to 60% of these tumors harbor ALK gene rearrangement as demonstrated by positivity for ALK IHC. ALK inhibitors like crizotinib or ceritinib can be given for advanced metastatic tumors.

Keywords

inflammatory myofibroblastic tumor - kidney - ALK inhibitors

Patient Consent

The authors certify that they have obtained all appropriate patient consent.




Publication History

Article published online:
06 December 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Yamamoto H. Inflammatory myofibroblastic tumour. In: Antonescu CR BJ, Cunha IW, Dei Tos AP. , et al, eds. World Health Organization Classification of Tumours. 5th ed. Soft Tissue and Bone Tumours. Lyon, France: IARC Press; 2020: 109-111
    Google Scholar
  • 2 Dogan MS, Doganay S, Koc G. et al. Inflammatory myofibroblastic tumor of the kidney and bilateral lung nodules in a child mimicking Wilms tumor with lung metastases. J Pediatr Hematol Oncol 2015; 37 (06) e390-e393
    CrossrefPubMedGoogle Scholar
  • 3 Dalton BG, Thomas PG, Sharp NE. et al. Inflammatory myofibroblastic tumors in children. J Pediatr Surg 2016; 51 (04) 541-544
    CrossrefPubMedGoogle Scholar
  • 4 Tareen B, Faith H, Waheed A, Ullah A, Kavuri SK. Anaplastic lymphoma kinase (ALK)-negative inflammatory myofibroblastic tumor of the kidney in a nine-month-old girl. Cureus 2022; 14 (03) e23289
    PubMedGoogle Scholar
  • 5 Patnana M, Sevrukov AB, Elsayes KM, Viswanathan C, Lubner M, Menias CO. Inflammatory pseudotumor: the great mimicker. AJR Am J Roentgenol 2012; 198 (03) W217-27
    CrossrefPubMedGoogle Scholar
  • 6 Brunn H. Two interesting benign lung tumors of contradictory histopathology. Remarks on the necessity for maintaining the chest tumor registry. J Thorac Cardiovasc Surg 1939; 9 (02) 9119-9131
    Google Scholar
  • 7 Umiker WO, Iverson L. Postinflammatory tumors of the lung; report of four cases simulating xanthoma, fibroma, or plasma cell tumor. J Thorac Surg 1954; 28 (01) 55-63
    PubMedGoogle Scholar
  • 8 Uruga H, Mino-Kenudson M. ALK (D5F3) CDx: an immunohistochemistry assay to identify ALK-positive NSCLC patients. Pharm Genomics Pers Med 2018; 11: 147-155
    Google Scholar
  • 9 Taheri D, Zahavi DJ, Del Carmen Rodriguez M. et al. For staining of ALK protein, the novel D5F3 antibody demonstrates superior overall performance in terms of intensity and extent of staining in comparison to the currently used ALK1 antibody. Virchows Arch 2016; 469 (03) 345-350
    CrossrefPubMedGoogle Scholar
  • 10 Erik T, Sylvie L, Jin-Haeng C. et al. ALK testing with IHC. In: Ming Sound T, Fred RH, Yasushi Y. eds. IASLC Atlas of ALK and ROS1 Testing in Lung Cancer. 2nd ed. Colorado, USA:: Editorial Rx Press; 2016: 25-32
    Google Scholar
  • 11 Cabillic F, Hofman P, Ilie M. et al. ALK IHC and FISH discordant results in patients with NSCLC and treatment response: for discussion of the question-to treat or not to treat?. ESMO Open 2018; 3 (06) e000419
    CrossrefPubMedGoogle Scholar
  • 12 Lenders JW, Pacak K, Walther MM. et al. Biochemical diagnosis of pheochromocytoma: which test is best?. JAMA 2002; 287 (11) 1427-1434
    CrossrefPubMedGoogle Scholar
  • 13 Ooms AHAG, Vujanić GM, D'Hooghe E. et al. Renal tumors of childhood-a histopathologic pattern-based diagnostic approach. Cancers (Basel) 2020; 12 (03) 729
    CrossrefPubMedGoogle Scholar
  • 14 Cook JR, Dehner LP, Collins MH. et al. Anaplastic lymphoma kinase (ALK) expression in the inflammatory myofibroblastic tumor: a comparative immunohistochemical study. Am J Surg Pathol 2001; 25 (11) 1364-1371
    CrossrefPubMedGoogle Scholar
  • 15 Itoh H, Namiki M, Yoshioka T, Itatani H. Plasma cell granuloma of the renal pelvis. J Urol 1982; 127 (06) 1177-1178
    CrossrefPubMedGoogle Scholar
  • 16 Vujanić GM, Berry PJ, Frank JD. Inflammatory pseudotumor of the kidney with extensive metaplastic bone. Pediatr Pathol 1992; 12 (04) 557-561
    CrossrefPubMedGoogle Scholar
  • 17 Tarhan F, Gül AE, Karadayi N, Kuyumcuoğlu U. Inflammatory pseudotumor of the kidney: a case report. Int Urol Nephrol 2004; 36 (02) 137-140
    CrossrefPubMedGoogle Scholar
  • 18 Boo YJ, Kim J, Kim JH, Kim CS, Suh SO. Inflammatory myofibroblastic tumor of the kidney in a child: report of a case. Surg Today 2006; 36 (08) 710-713
    CrossrefPubMedGoogle Scholar
  • 19 Ho PH, Chen SY, Hsueh C, Lai MW, Chao HC, Chang PY. Inflammatory myofibroblastic tumor of renal pelvis presenting with prolonged fever and abdominal pain in children: report of 1 case and review of literature. J Pediatr Surg 2005; 40 (11) e35-e37
    CrossrefPubMedGoogle Scholar
  • 20 Czerwinski M, Dave S. Pediatric renal inflammatory myofibroblastic tumours: A case report and review of the etiology and management options. Can Urol Assoc J 2012; 6 (04) E150-E153
    CrossrefPubMedGoogle Scholar
  • 21 Palaskar S, Koshti S, Maralingannavar M, Bartake A. Inflammatory myofibroblastic tumor. Contemp Clin Dent 2011; 2 (04) 274-277
    CrossrefPubMedGoogle Scholar
  • 22 Kapusta LR, Weiss MA, Ramsay J, Lopez-Beltran A, Srigley JR. Inflammatory myofibroblastic tumors of the kidney: a clinicopathologic and immunohistochemical study of 12 cases. Am J Surg Pathol 2003; 27 (05) 658-666
    CrossrefPubMedGoogle Scholar
  • 23 Mossé YP, Voss SD, Lim MS. et al. Targeting ALK with crizotinib in pediatric anaplastic large cell lymphoma and inflammatory myofibroblastic tumor: a Children's Oncology Group study. J Clin Oncol 2017; 35 (28) 3215-3221
    CrossrefPubMedGoogle Scholar
  • 24 Mittal A, Gupta A, Rastogi S, Barwad A, Sharma S. Near-complete response to low-dose ceritinib in recurrent infantile inflammatory myofibroblastic tumour. Ecancermedicalscience 2021; 15: 1215
    PubMedGoogle Scholar
  • 25 Jo VY, Fletcher CD. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathology 2014; 46 (02) 95-104
    CrossrefPubMedGoogle Scholar