The rationale for nonsteroidal anti-inflammatory drug therapy for inflammatory myofibroblastic tumors: a Children's Oncology Group study
Section snippets
Methods
Stained and unstained initial biopsy slides of previously diagnosed and treated large IMTs were acquired without identifiers from members of the Surgical Discipline Committee of the Children's Oncology Group who were associated with 5 clinical centers.1
Results
Eighteen samples were reviewed (Table 1). Eleven met all histological criteria for the diagnosis of IMT, 6 cases were considered consistent with IMT, and 1 case had hypercellularity, atypia, abundant ganglionlike cells, and a round cell transformation consistent with malignant transformation of IMT. Immunohistochemistry was performed on formalin-fixed paraffin-embedded tissue for ALK-1 in 17 of 18 cases. Six (35%) of 17 cases displayed reactivity for ALK-1 (Fig. 1), all of which showed a
Discussion
Composed of organized vascular inflammatory tissue and myofibroblasts, IMTs often attain large size, invade normal tissues, and obstruct hollow organs. A component of the larger inflammatory pseudotumor histological grouping, they can occur in almost any part of the body and most frequently obstruct ureters, bowel, bile ducts, and bronchi [5], [6], [7]. Traditional treatment consists of attempts at radical surgical extirpation that often entails resection of involved or adjacent organs and
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Presented at the 56th Annual Meeting of the Section on Surgery of the American Academy of Pediatrics, San Francisco, California, October 8-10, 2004.