Recurrent inflammatory myofibroblastic tumors (IMTs) of bladder managed with transurethral resection; case report

Bladder IMTs are uncommon subtypes of sarcoma arising from mucosal epithelium and mesentery. They can occur various organs like eyes, nose, mouth, digestive tract, lungs, and genital and urinary tracts [1]. Typically benign, these tumors can occasionally exhibit local aggression. Diagnosis challenging due to its pathology confusion with bladder sarcomas, immunohistochemical analysis may be necessary to differentiate [6]. Here we report a 52 years old lady with recurrent bladder IMT who was treated with transurethral resection of bladder tumor(TURBT). This case report is in line with criteria from updated c Surgical CAse REport (SCARE) guidelines. [11]Importance of this report is help us to understand nature, prognosis and management of this rare tumor.

A 52 years old lady presented from Silte,Ethiopia with gross painless hematuria of 2 weeks duration associated storage Lower urinary tract symptoms. She had TURBT done 8 months back for this she is on follow up at Outpatient department.

Inflammatory myofibroblastic tumor (IMT) is a very rare mesenchymal neoplasm that tends to occur in children and young adults, with a mean age of 9 to 10 years. Because of its highly cellular nature and aggressive behavior, it can be confused with malignancy. Pathologic evaluation and full histopathological analysis is recommended for establishing diagnosis. Clinical presentation mostly dependant on site of origin in case of bladder IMT gross hematuria most common presentation, supra pubic pain, storage lower urinary tract symptoms and if bleeding is severe enough they may have systemic symptoms of anemia.Management is aimed at complete local resection through transurethral resection or partial cystectomy is the more advisable treatment.Anaplastic lymphoma kinase (ALK) inhibitor can be considered for selected patients.

Inflammatory myofibroblastic tumor of bladder is benign rare tumor.Both diagnosis and management are challenging due to pathology confusion with sarcomas and rarity of tumor. Transurethral resection is choice of management and partial cystectomy is also alternative. Crizotinib, an anaplastic lymphoma kinase (ALK) inhibitor can be considered in selected patients. Though metastasis and recurrence rare post-operative follow up with clinical and cystoscopy is crucial.