Anaplastic lymphoma kinase positive inflammatory myofibroblastic tumor of the urachus: A rare neoplasm in an unusual location.
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Date
2016-01
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Abstract
Inflammatory myofibroblastic tumors (IMTs) are uncommon benign neoplasms
in the abdomen, and urachal involvement is very rare. IMT of the urachus is
usually mistaken clinically and radiologically for a malignant tumor. The tumor
has spindle cell proliferation with a prominent inflammatory infiltrate and myxoid
degeneration favoring other designations such as inflammatory pseudotumor and
fibromyxoid pseudotumor. Complete excision is the treatment of choice. The case
documented here was in a 50‑year‑old male, with an abdominal mass diagnosed
on computed tomography scan as adenocarcinoma of urachus infiltrating the
bladder. Histopathology showed a benign spindle cell tumor invading bladder
muscle. Immunohistochemistry aided in diagnosing an anaplastic lymphoma
kinase (ALK)‑1 positive IMT. Approximately, 50% of the IMTs show ALK positivity,
and though when present, it indicates neoplastic nature of the spindle cells, the
pathogenesis of IMT is still elusive. The urachal IMTs need documentation in
literature for their rarity and diagnostic dilemma posed by them.
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Keywords
Anaplastic lymphoma kinase‑1 positivity, inflammatory myofibroblastic tumor, urachus
Citation
Venkatesh Kusuma, Madhusudhan H R. Anaplastic lymphoma kinase positive inflammatory myofibroblastic tumor of the urachus: A rare neoplasm in an unusual location. Indian Journal of Pathology & Microbiology. 2016 Jan-Mar 59(1): 93-95.