Рентгенология & Радиология, 2015, LIV 126-131

Malignant inflammatory myofibroblastic tumor – immunohistochemical diagnosis and optimal treatment
  1. Marinova, I. Mihaylova
Abstract.

We present a clinical case of recurrent myofibroblastic tumor in the soft tissues of left scapular region of 27 years old female patient, who has undergo 3 operations for this tumor. The history of the disease started in 2008. The first local recurrence in 2009 was diagnosed as nodular fasciitis – proliferative type. The second local recurrence was in March 2013 when a left partial resection of the scapula was performed. The immunohistochemical staining has shown a malignant inflammatory myofibrobalstic tumor. The postoperative radiotherapy has achieved local tumor control for 2 years. The difficulties in immunohistochemical differential diagnosis of sarcomas with myofibroblasic differentiation was discussed. These subtypes of sarcomas include a number of differentiated lesions, as juvenile fibrosarcoma, inflammatory myofibrobalstic tumor and a separate pathology type – low grade malignant myofibrobalstic sarcoma. The radical surgery is the optimal treatment of low grade malignant myofibrobalstic sarcomas, with extended resection margins. A high risk of local recurrences is linked with impossibility of such radical surgery. These local recurrences required postoperative radiotherapy at a total dose of 60 Gy.

Key words: INFLAMMATORY MYOFIBROBLASTIC TUMОR. LOWGRADE MYOFIBROBLASTIC SARCOMA. IMMUNOHISTOCHEMICAL STAINING. RADICAL SURGERY TREATMENT. LOCAL RECURRENCES. POSTOPERATIVE RADIOTHERAPY