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Intraosseous Inflammatory Myofibroblastic Tumor of the Twelfth Thoracic VertebraReport of a Rare Case with Histological Diagnosis and Surgical Treatment
Mazda Farshad, MD, MPH1; Beata Bode, MD2; Kan Min, MD1
1 Department of Orthopaedics, University of Zurich, Balgrist University Hospital, Forchstrasse 340, 8008 Zurich, Switzerland. E-mail address for M. Farshad: mazda.farshad@balgrist.ch
2 Institute of Surgical Pathology, University Hospital Zurich, Ramistrasse 71, 8006 Zurich, Switzerland
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Investigation performed at Balgrist University Hospital and Institute of Surgical Pathology, University of Zurich, Zurich, Switzerland



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 May 08;3(2):e46 1-5. doi: 10.2106/JBJS.CC.L.00316
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Extract

Inflammatory myofibroblastic tumor (IMT) consisting of a spindle cell proliferation admixed with an inflammatory component is an uncommon mesenchymal lesion that can arise in multiple anatomic locations1,2. Because of its heterogenic histologic appearance, different synonyms have been used throughout the literature, including inflammatory pseudotumor, fibromyxoid lesion, pseudosarcomatous myofibroblastic tumor, and plasma cell granuloma2. Although IMTs have been considered benign proliferation of myofibroblasts, they have potential for recurrence, persistent local growth3, and local aggressive behavior2,4. Their malignant potential is controversal5. The rare entity of multilocality has been described6,7 and might even be interpreted as metastatic occurrence8. Although very rare, even paraneoplastic symptoms have been attributed to IMT9. While IMTs seem to localize predominantly in the viscera (e.g., lung) and soft tissue (e.g., mesentery and omentum)2, they arise very infrequently in bone. Their occurrence has been reported in cranial bones10-12, long bones13,14, the sacrum9, and the iliac bone15. IMTs in the spinal system are also reported16-19, but primary occurrence in a vertebral body is extremely rare1. Roberts et al. described a case of an IMT of the T10 vertebra compressing the thecal sac and involving the paravertebral muscles20, but it was unclear whether the IMT originated from the vertebral bone or from the surrounding soft tissues. We present a rare case of a localized IMT in the T12 vertebra, and we describe the difficulties involved in histological diagnosis and treatment. The patient was informed that data concerning the case would be submitted for publication, and she provided consent.
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