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Case Reports in Surgery
Volume 2016 (2016), Article ID 8593242, 3 pages
http://dx.doi.org/10.1155/2016/8593242
Case Report

Metastatic Inflammatory Myofibroblastic Tumor of the Spleen: A Case Report and Review of the Literature

1Department of Surgery, St. Claraspital, Basel, Switzerland
2Department of Pathology, Viollier AG, Basel, Switzerland
3Department of Oncology, St. Claraspital, Basel, Switzerland

Received 7 July 2016; Accepted 13 November 2016

Academic Editor: Gabriel Sandblom

Copyright © 2016 Luca Koechlin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Inflammatory myofibroblastic tumors (IMT) of the spleen are rare neoplasms and only little is known about the origin and behavior of these tumors. Here we report the case of a 37-year-old woman with an atypical spindle cell neoplasm showing features strongly suggesting an IMT of the spleen with hepatic metastasis. Methods. A 37-year-old patient had been complaining about pain in the left upper abdomen for the last two months. A CT scan revealed a tumor mass in her spleen and liver. After complete staging, a splenectomy and atypical liver resection of segments VII and VIII were performed. Literature was screened for similar cases and existing further literature. Results. A R0 resection was achieved. Histological analysis showed a multinodular infiltration of the spleen by an atypical mesenchymal neoplasia. Immunohistochemically there was an expression of histiocytic markers (CD4, CD68) as well as smooth muscle cell markers (SMA, H-Caldesmon) in the tumor cells. A diagnosis of an atypical spindle cell neoplasm showing features most suggestive of an IMT was rendered. Conclusion. Synchronous hepatic metastasis of an IMT of the spleen is a rarity. Therefore no experience in the treatment of these tumors exists. Fibroblastic reticular cell tumor is a differential diagnosis, but differentiation of these two entities is difficult.