DOI QR코드

DOI QR Code

Anthracycline 기반 항암화학요법에 반응을 한 염증성 근섬유모세포종

Inflammatory Myofibroblastic Tumor Showing Durable Remission after Anthracycline-Containing Cytotoxic Chemotherapy: Report of a Case

  • 김달용 (울산대학교 의과대학 서울아산병원 내과) ;
  • 박한승 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김선목 (울산대학교 의과대학 서울아산병원 내과) ;
  • 박지현 (울산대학교 의과대학 서울아산병원 내과) ;
  • 홍용상 (울산대학교 의과대학 서울아산병원 내과) ;
  • 이재련 (울산대학교 의과대학 서울아산병원 내과) ;
  • 서철원 (울산대학교 의과대학 서울아산병원 내과)
  • Kim, Dal-Yong (Department of Internal Medicine University of Ulsan College of Medicine) ;
  • Park, Han-Seung (Department of Internal Medicine University of Ulsan College of Medicine) ;
  • Kim, Sun-Mok (Department of Internal Medicine University of Ulsan College of Medicine) ;
  • Park, Ji-Hyun (Department of Internal Medicine University of Ulsan College of Medicine) ;
  • Hong, Yong-Sang (Department of Internal Medicine University of Ulsan College of Medicine) ;
  • Lee, Jae-Lyun (Department of Internal Medicine University of Ulsan College of Medicine) ;
  • Suh, Cheol-Won (Department of Internal Medicine University of Ulsan College of Medicine)
  • 발행 : 2012.06.01

초록

염증성 근섬유모세포종에 대한 정립된 치료 방침은 없다. 수술이 완치를 위한 치료로 알려져 있으나 조직 검사상 염증세포의 침윤이 있고 기존에 보고된 증례들을 바탕으로 하여 스테로이드 또는 비스테로이드성 염증약물도 하나의 치료 방침이 될 수 있겠다. 본 증례와 같이 급속히 진행하는 종양의 경우 연부 조직 육종에 준한 anthracycline 기반 항암 화학요법을 시행하는 것이 질병을 조절하고 생존기간의 연장하는 데에 적절한 선택이 될 수 있을 것으로 보이며 이것을 뒷받침하기 위한 추가 연구가 필요하겠다.

An inflammatory myofibroblastic tumor (IMT) is a rare disease entity, and the clinical characteristics range from indolent to aggressive forms. No established management for patients with unresectable or aggressive IMT is available. We report on a 62-year-old patient with aggressive IMT who achieved a durable partial response lasting 12 months after anthracycline-containing cytotoxic chemotherapy without corticosteroids. The patient was admitted for an evaluation of progressive weight loss and lower abdominal pain lasting for 2 weeks. Abdominopelvic computed tomography revealed a 10 cm sized heterogeneous mass in the mesentery that encased the superior mesenteric artery and a liver metastasis. The diagnosis of IMT was confirmed by percutaneous core needle biopsy of the mesenteric mass. Systemic chemotherapy was performed after confirming disease progression during a 1 month observation period. A partial response was obtained after two cycles of chemotherapy. Anthracycline-containing cytotoxic chemotherapy could be a treatment option for patients with aggressive IMT.

키워드

참고문헌

  1. Ma Z, Hill DA, Collins MH, et al. Fusion of ALK to the Ran-binding protein 2 (RANBP2) gene in inflammatory myofibroblastic tumor. Genes Chromosomes Cancer 2003; 37:98-105. https://doi.org/10.1002/gcc.10177
  2. Applebaum H, Kieran MW, Cripe TP, et al. The rationale for nonsteroidal anti-inflammatory drug therapy for inflammatory myofibroblastic tumors: a Children's Oncology Group Study. J Pediatr Surg 2005;40:999-1003. https://doi.org/10.1016/j.jpedsurg.2005.03.016
  3. Narla LD, Newman B, Spottswood SS, Narla S, Kolli R. Inflammatory pseudotumor. Radiographics 2003;23:719-729. Erratum in: Radiographics 2003;23:1702. https://doi.org/10.1148/radiographics.23.6.g03nv341702
  4. Lim HC, Jahng JH, Park JW, et al. Two cases of inflammatory myofibroblastic tumors of the liver that resolved with conservative care. Korean J Med 2008;75(5 Suppl): S738-S744.
  5. Meis JM, Enzinger FM. Inflammatory fibrosarcoma of the mesentery and retroperitoneum: a tumor closely simulating inflammatory pseudotumor. Am J Surg Pathol 1991;15: 1146-1156. https://doi.org/10.1097/00000478-199112000-00005
  6. Zen Y, Kasahara Y, Horita K, et al. Inflammatory pseudotumor of the breast in a patient with a high serum IgG4 level: histologic similarity to sclerosing pancreatitis. Am J Surg Pathol 2005;29:275-278. https://doi.org/10.1097/01.pas.0000147399.10639.f5
  7. Su LD, Atayde-Perez A, Sheldon S, Fletcher JA, Weiss SW. Inflammatory myofibroblastic tumor: cytogenetic evidence supporting clonal origin. Mod Pathol 1998;11:364-368.
  8. Trojan A, Stallmach T, Kollias S, Pestalozzi BC. Inflammatory myofibroblastic tumor with CNS involvement. Onkologie 2001;24:368-372. https://doi.org/10.1159/000055109
  9. Dishop MK, Warner BW, Dehner LP, et al. Successful treatment of inflammatory myofibroblastic tumor with malignant transformation by surgical resection and chemotherapy. J Pediatr Hematol Oncol 2003;25:153-158. https://doi.org/10.1097/00043426-200302000-00014
  10. Butrynski JE, D'Adamo DR, Hornick JL, et al. Crizotinib in ALK-rearranged inflammatory myofibroblastic tumor. N Engl J Med 2010;363:1727-1733. https://doi.org/10.1056/NEJMoa1007056

피인용 문헌

  1. A Case of Recurrent Pulmonary Inflammatory Myofibroblastic Tumor with Aggressive Metastasis after Complete Resection vol.75, pp.4, 2012, https://doi.org/10.4046/trd.2013.75.4.165
  2. Case of an Inflammatory Myofibroblastic Tumor of the Duodenum vol.72, pp.1, 2012, https://doi.org/10.4166/kjg.2018.72.1.28