Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1432
Peer-review started: September 5, 2021
First decision: October 11, 2021
Revised: October 21, 2021
Accepted: December 23, 2021
Article in press: December 23, 2021
Published online: February 6, 2022
Processing time: 140 Days and 16.5 Hours
Inflammatory myofibroblastic tumors (IMTs) are defined as tumors composed of differentiated myofibroblastic spindle cells, usually accompanied by numerous plasma cells and lymphocytes, and classified as intermediate (occasionally metastatic) by the World Health Organization. Its pathogenesis and biological behavior have not yet been elucidated. Breast IMT is extremely rare, and prosthesis implantation combined with IMT has not been reported. This study reports a case of IMT following resection of a malignant phyllodes tumor of the left breast and implantation of a prosthesis.
A 41-year-old female presented to our hospital with a mass in the left breast for 3 mo. The patient had undergone resection of a large mass in her left breast pathologically diagnosed as a malignant phyllodes tumor and implantation of a prosthesis five years prior. Ultrasonic examination revealed an oval mass in the left breast, and the patient underwent left breast mass resection and prosthesis removal. Light microscopy revealed the spindle cells to be diffusely proliferated, with a large number of neutrophils, lymphocytes, and plasma cell infiltration. Immunohistochemical staining revealed that the spindle cells were partially positive for smooth muscle actin, which is positive for BCL-2 and cluster of differentiation (CD) 99 but were negative for anaplastic lymphoma kinase, cytokeratin, S-100 protein, desmin, and CD34. The final diagnosis was IMT. No recurrence or metastasis was observed during the 5-year postoperative follow-up.
Prosthesis implantation may be one of the causes of IMT, but further investigation is necessary to prove it.
Core Tip: We believe that our study makes a significant contribution to the literature because inflammatory myofibroblastic tumors (IMTs) of the breast are rare and unique; however, whether they are reactive or neoplastic in nature remains unelucidated. This case presented the opportunity to review studies regarding cases of inflammatory myofibroblastic breast tumors and determine whether they are reactive lesions due to an exaggerated response to tissue injury or indicate a true neoplastic process. This report prompts that prosthesis implantation may cause IMT.