Pelvic epithelioid inflammatory myofibroblastic sarcoma complicated with peritoneal metastasis: a case report
10.3760/cma.j.cn431274-20240317-00440
- VernacularTitle:盆腔上皮样炎性肌纤维母细胞肉瘤合并腹膜转移1例
- Author:
Wenpeng HUANG
1
;
Lele SONG
;
Xiaoyan XIAO
;
Liming LI
;
Yongkang QIU
;
Jianbo GAO
;
Lei KANG
Author Information
1. 北京大学第一医院核医学科，北京 100034
- Publication Type:Journal Article
- Keywords:
Pelvic neoplasms;
Epithelioid inflammatory myofibroblastic sarcoma;
Tomography, X-ray computed
- From:
Journal of Chinese Physician
2025;27(3):357-360
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical features, imaging features and diagnosis and treatment process of a female pelvic epithelioid inflammatory myofibroblastic sarcoma (EIMS) with peritoneal metastasis, so as to improve the clinical understanding and diagnostic ability of the disease and avoid misdiagnosis and missed diagnosis.Methods:The clinical data of a female patient with pelvic EIMS combined with peritoneal metastasis in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Results:The triad examination of the patient involved an irregular solid mass in the pelvic cavity about 8.0 cm×9.0 cm in size. Laboratory examination revealed human epididymal protein 4(HE4)154.00 pmol/L. The ultrasonography showed multiple low-echo masses in deep pelvic cavity with unclear boundary and uneven internal echo, and color doppler flow imaging (CDFI) showed abundant internal blood flow signals. Enhanced CT showed uneven and obvious enhancement of the lesion. Pathological examination showed the infiltration of inflammatory cells in the mucous interstitial background. The tumor cells were round and epithelioid, with large nuclei, deep staining and obvious nucleolus. Immunohistochemistry showed anaplastic lymphoma kinase (ALK) positive, and molecular pathology fluorescence in situ hybridization showed ALK gene amplification (positive). Combined with pathological, immunohistochemical and genetic tests, EIMS was diagnosed. Conclusions:EIMS should be considered when there are single or multiple solid or cystic nodules or masses in the pelvic cavity with obvious enhancement, invasive growth and peritoneal implantation metastasis, and the correct diagnosis can be made according to the pathological findings, immunohistochemistry and genetic test results.
