Inflammatory Myofibroblastic Tumor of the Urinary Bladder Presenting as a Radiological cT3 Mass: A Case Report and Narrative Review of 89 Cases.
Hao Xiang Chen, Shun-Lin Liu, Chi-Ping Huang et al.
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Case in brief
A 57-year-old man with persistent dysuria and no gross hematuria had a 30×29 mm anterior bladder wall mass with perivesical fat stranding on computed tomography, interpreted as cT3N0M0. Transurethral resection showed spindle-cell proliferation in myxoid stroma with a mixed inflammatory infiltrate. Diffuse, moderate-to-strong ALK positivity and negative ROS staining supported inflammatory myofibroblastic tumor. Cystoscopic surveillance found no intravesical recurrence; stable residual perivesical soft tissue was seen at 6 months. He remained recurrence-free with his bladder intact 51 months after resection.
What made this case unusual
The tumor appeared to invade perivesical tissue radiologically, mimicking locally advanced urothelial carcinoma, yet the patient remained recurrence-free after transurethral resection with his bladder intact.
Diagnostic / clinical pearl
A bladder mass with apparent extravesical invasion on computed tomography may be inflammatory myofibroblastic tumor rather than advanced urothelial carcinoma; tissue diagnosis should guide surgical decisions.