CT Analysis of Inflammatory Myofibroblastic Bladder Tumors

By: Vanessa A. Carter, BS
Posted: Thursday, June 1, 2023

According to Pan Liang, MD, PhD, of the First Affiliated Hospital, Zhengzhou University, Henan, China, and colleagues, the intermediate biologic potential of inflammatory myofibroblastic tumors is poorly understood, which poses difficulties in diagnosis and treatment. Their recent study, published in Molecular and Clinical Oncology, aimed to describe characteristic computed tomography (CT) findings in patients with inflammatory myofibroblastic bladder tumors confirmed by pathology.

“The bladder inflammatory myofibroblastic tumors had certain characteristic CT findings that differ from other bladder lesions,” the authors concluded. “The present study of cases suggested there may be a certain relationship between Ki67 value and radiology feathers of the bladder [tumors], but the number of cases is limited, and further study is needed for in-depth analysis.”

The investigators retrospectively reviewed the unenhanced and contrast-enhanced CT images of nine patients with pathologically confirmed, inflammatory myofibroblastic bladder tumors. Tumor characteristics such as growth pattern, margin, boundary, density, enhancement pattern, location, diameter, and Ki67 value were assessed and compared.

Tumor growth patterns included endophytic (n = 4), exophytic (n = 2), and mixed (n = 3). Mean Ki67 values for irregular and no blood clots were 18% and 12%, respectively. Morphologic manifestations of the tumors consisted of polypoid (n = 5) limited thick-walled (n = 3), or cauliflower‑like soft-tissue mass with a wide base in the cavity (n = 1). Of note, symmetrical changes in the center of each lesion were observed in the cauliflower-like and polypoid masses after CT enhancements.

Lesions appeared as either heterogeneous (n = 6) or ring-shaped (n = 3), with smooth (n = 8) or lobulated (n = 1) tumor margins. Additionally, tumor boundaries were either clear (n = 7) or ill-defined (n = 2). Overall, an inflammatory myofibroblastic tumor of the bladder manifests as a single polypoid nodule in the superior wall, has ring-shaped enhancement with symmetrical change after enhancement, and demonstrates mostly endophytic growth.

Disclosure: The study authors reported no conflicts of interest.

Molecular and Clinical Oncology