title: Metastatic Inflammatory Myofibroblastic Tumor of the Spleen: A Case Report and Review of the Literature.
abstract: Introduction.Inflammatory myofibroblastic tumors (IMT) of the spleen are rare neoplasms and only little is known about the origin and behavior of these tumors. Here we report the case of a 37-year-old woman with an atypical spindle cell neoplasm showing features strongly suggesting an IMT of the spleen with hepatic metastasis.Methods.A 37-year-old patient had been complaining about pain in the left upper abdomen for the last two months. A CT scan revealed a tumor mass in her spleen and liver. After complete staging, a splenectomy and atypical liver resection of segments VII and VIII were performed. Literature was screened for similar cases and existing further literature.Results.A R0 resection was achieved. Histological analysis showed a multinodular infiltration of the spleen by an atypical mesenchymal neoplasia. Immunohistochemically there was an expression of histiocytic markers (CD4, CD68) as well as smooth muscle cell markers (SMA, H-Caldesmon) in the tumor cells. A diagnosis of an atypical spindle cell neoplasm showing features most suggestive of an IMT was rendered.Conclusion.Synchronous hepatic metastasis of an IMT of the spleen is a rarity. Therefore no experience in the treatment of these tumors exists. Fibroblastic reticular cell tumor is a differential diagnosis, but differentiation of these two entities is difficult.
authors.affiliation: Department of Surgery, St. Claraspital, Basel, Switzerland.
authors.forename: Luca
authors.identifier: 0000-0002-2929-8600
authors.initials: L
authors.lastname: Koechlin
authors.affiliation: Department of Pathology, Viollier AG, Basel, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Zettl
authors.affiliation: Department of Oncology, St. Claraspital, Basel, Switzerland.
authors.forename: Dieter
authors.initials: D
authors.lastname: Koeberle
authors.affiliation: Department of Surgery, St. Claraspital, Basel, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: von Flüe
authors.affiliation: Department of Surgery, St. Claraspital, Basel, Switzerland.
authors.forename: Martin
authors.identifier: 0000-0002-2126-2996
authors.initials: M
authors.lastname: Bolli