Diagnostic challenges and clinical management of inflammatory myofibroblastic tumor: a retrospective case series study

IMT is a tumor with "low malignant potential" or "borderline" characteristics. It is neither a typical benign tumor nor a highly malignant cancer, but occupies an intermediate gray zone. It can occur at multiple sites in the body, most commonly in the lungs, and has been reported across all age groups. Through the analysis of six cases of IMT with unusual primary sites, this study found that even with low-grade pathological features, the tumor can still exhibit aggressive biological behavior, including postoperative recurrence and distant metastasis, when arising in atypical locations such as the sacrum or nasal cavity. This suggests that the clinical management of IMT should not rely solely on pathological grading but should also involve a comprehensive evaluation incorporating the tumor's location and size. This case series contributes to broadening the understanding of the clinical spectrum of IMT, enhances awareness of IMT in rare sites, and provides important clinical rationale for long-term systematic follow-up and monitoring for all patients with IMT.