Inflammatory myofibroblastic tumor of urinary bladder with severe hematuria A Case report and literature review

Rationale: Inflammatory myofibroblastic tumor (IMT) is a rare intermediate soft tissue tumor. Rarely occurring in the urinary bladder, MTs is composed of myofibroblast differentiated spindle cells and accompanied by numerous inflammatory cells, plasma cells and/or Lymphocytes. Patient concerns: A 28-year-old female, with history of 2 cesarean sections 8 years ago and 2 years ago, was admitted to the emergency department for a 7-day ongoing gross hematuria with clots. Diagnoses: A cystoscopy showed a tumor near the bladder neck, computed tomography (CT) showed a mass and massive blood clots in the bladder. Finally, postoperative pathological examination confirmed a diagnosis of inflammatory myofibroblastic tumor of bladder. Interventions: The patient was given rehydration and blood transfusion to improve the general condition. Then, emergency transurethral resection of the bladder tumor was performed. Outcomes: No metastases to lymph nodes and other organs were found, and no tumor progression was revealed during 3months of follow-up. Lessons: IMTs rarely occur in the urinary bladder. Due to the lack of specificity in clinical symptoms, it's difficult to arrive at a definite diagnosis before operation. Therefore, usually, the final diagnosis depends on histomorphological features and the immunohistochemical profile. Further case studies are required to study the biological behavior of this condition.