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INFLAMMATORY MYOFIBROBLASTIC TUMOUR OF THE KIDNEYS – CASE REPORT

Dimo Nikolov, Dessyslava Nikolaeva, Radi Lukanov, E. Ahmed, Valentin Ikonomov

Abstract

Introduction: Inflammatory myofibroblastic tumour (IMT) is a rare condition which includes proliferation of myofibroblasts accompanied with inflammatory infiltrates. It is known to have a wide age range and to affect both males and females. Although its most common site is the lungs, IMT also has extrapulmonary locations which most often include the bladder and rarely the kidneys. Its biological nature varies from a completely benign to a malignant tumour with fatal outcome.

Material and Methods: We report a case of a 61-year-old woman, admitted to a hospital with high temperature and anaemia, five months after left nephrectomy due to a myofibroblastic tumour of the kidney. The performed laboratory tests revealed a significant impairment of the GFR and anaemic syndrome. The conducted MRI-scan found multiple hypodense lesions in the right kidney with enlarged paraaortical lymph nodes. PET-scan and CT-scan confirmed the findings. The results of the examinations illustrated a slow progressive chronic failure of the solitary kidney, which suggested a paraneoplastic process due to recurrence of the IMT.

Results: Because of the high CRP rates, the patient underwent an antibiotic therapy with Meropenem, without any clinical and laboratory improvement and deterioration of the signs of inflammation. The findings of hypodense lesions and chronic failure combined with the contraindication of nephrectomy, because of a solitary kidney, suggested the admission of Prednisolone, as this type of tumour is cortisol-sensitive. In connection with the glucocorticoids usage, the patient is scheduled for bone density test. She remains under constant observation.

Conclusions: The case presents an uncommon occurrence of inflammatory myofibroblastic tumour with the kidneys as a site of progression. It illustrates the recurrent nature of this type of neoplasm and the complications that it brings, according to the organs, which affects.


Keywords

myofibroblastic tumour, kidney neoplasm


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