Inflammatory Myofibroblastic Tumor of the Prostate Gland: A Case Report From North-Central Nigeria

Inflammatory myofibroblastic tumors (IMTs) are mesenchyme-derived tumors of undetermined malignant potential, generally considered low-grade tumors. They occur within various organs, with the abdominal cavity as the most common site of occurrence. The male genitourinary system, especially the prostate gland, is among the least common sites of occurrence. IMTs are generally diagnosed in the young, where they present as circumscribed masses with symptoms referable to the location and size. Occasionally, however, they present in the elderly. The etiopathogenesis is postulated to be related to an abnormality in chromosome 2p23.5, and association with anaplastic lymphoma receptor tyrosine kinase (ALK) positivity on immunohistochemistry (IHC) has therapeutic and prognostic implications. Distinguishing IMTs from non-neoplastic mimics like inflammatory pseudotumor (IPT) is important because they have similar microscopic features, characterized by benign spindle and stellate cells of variable cellularity, admixed with mixed inflammatory cell infiltrates in a fibrocollagenous background. Surgery is the treatment of choice, with a favorable outcome in most cases. Targeted therapy with the tyrosine kinase inhibitor (TKI) crizotinib is increasingly touted in recurrent cases or those not amenable to surgery. We present a case of IMT in a 77-year-old Nigerian male who was clinically diagnosed as a case of benign prostatic hyperplasia (BPH), in order to highlight the imperative for a high index of suspicion in the histopathological evaluation of prostatic lesions.