What is the inflammatory myofibroblastic tumor on the head and neck?

What is the inflammatory myofibroblastic tumor on the head and neck? What is inflammatory myofibroblastoma tumor (IMT)?

What is inflammatory myofibroblastoma tumor (IMT)?

Inflammatory myofibroblastic tumor (IMT) is a unique tumor composed of myofibroblasts and fibroblastic spindle cells, with infiltration of plasma cells, lymphocytes and/or eosinophils, and belongs to intermediate soft tissue tumors.

Part of the border is clear, there is a pseudo-capsule, and the border of some tumors is blurred, especially for recurrent MIT. The shape of the tumor is irregular and the border is unclear, showing infiltrating growth.

The disease mainly occurs in the soft tissues and internal organs of children and young adults. The head and neck are the parts where IMT is prone to occur outside the lungs, mainly in the orbits, throat, oral cavity, and nasal cavity.

The cause of IMT has not yet been fully elucidated. The latest research has found that IMT is related to genetic abnormalities (ALK gene abnormalities), and the expression of related proteins is enhanced, which induces abnormal proliferation of myofibroblasts, which leads to tumorigenesis.

What are the symptoms of head and neck IMT?

The clinical manifestations of IMT in the head and neck are similar to inflammation, and patients often see a doctor because of progressive swelling of the maxillofacial region and local pain. Some patients may be accompanied by systemic symptoms, such as fever, irritability, weight loss and so on.

Nasal IMT may cause nasal congestion, nose bleeding, and hypoosmia; forehead, pterygopalatine fossa IMT may have restricted opening; oropharynx, tonsil, tongue IMT may have dysphagia; orbital IMT may have tears, eye pain, eyeballs Extrusion and so on.

In imaging examinations, CT mainly manifests as soft tissue masses with uneven density, and necrosis and calcification are rare; MRI can better show the relationship between the lesion and surrounding tissues, and may have signs of invasion of adjacent muscles or accompanied by bone destruction.

How to treat?

Commonly used treatment methods include conservative treatment and surgical treatment, with surgical treatment being the mainstay.

Surgical treatment:

The principle of head and neck IMT surgery is to perform radical resection while preserving important structures as much as possible, giving priority to function. For tumors that have not been completely resected or patients with positive margins, postoperative radiotherapy and chemotherapy are supplemented.

Targeted therapy:

For some ALK-positive IMTs, especially those with difficulty in direct surgery or recurrence after surgery, the treatment of ALK-targeted drugs (crizotinib) has shown good application prospects.

Anti-inflammatory treatment:

Due to the presence of inflammatory cell infiltration in IMT, COX-2 inhibitors (Celebrex) have a certain therapeutic effect, and ultimately promote tumor cell apoptosis by blocking signal pathways such as NF-kB in tumor cells.

(source:internet, reference only)

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