INTRODUCTION
Inflammatory Myofibroblastic Tumor (IMT) is a rare intermediate softtissue neoplasm that can arise in virtually any organ, including the urinary bladder. Accurate diagnosis is challenging but crucial, as conservative treatment approaches may be feasible.
CASE PRESENTATION
An 11-year-old boy presented with dysuria and microscopic hematuria. Ultrasound and Computed Tomography (CT) revealed a bladder mass associated with right-sided ureterohydronephrosis. Multiparametric Magnetic Resonance Imaging (mpMRI), performed for local staging using the Vesical Imaging Reporting and Data System (VI-RADS), demonstrated moderate diffusion restriction of the lesion on Diffusion-Weighted Imaging (DWI). However, the extent of bladder wall invasion was not clearly defined. Dynamic Contrast-Enhanced (DCE) T1-weighted SPIR sequences showed disruption of the hypointense muscularis propria with early extension into the ureteral wall at the intramural segment. Histopathological examination of biopsy specimens confirmed an inflammatory myofibroblastic tumor with muscular layer involvement. The patient received five months of chemotherapy with methotrexate and vinblastine, followed by partial cystectomy and ureteral reimplantation. Three years after treatment, follow-up MRI demonstrated no evidence of locoregional recurrence, indicating a complete response.
CONCLUSION
In this rare case of pediatric bladder IMT, MRI proved valuable for assessing locoregional tumor extent, guiding surgical planning, and evaluating treatment response. In particular, the case highlights the potential role of VI-RADS-based assessment in the staging and management of bladder IMT.
P. P. Arcuri, Simonetta Antonelli, E. Galea et al.· Reviews on recent clinical t...· 0 citations
Parkinson’s disease (PD) is the second most common age-related neurodegenerative disorder, yet it remains unclear whether cortical architecture can reveal biologically distinct subtypes with distinct molecular and serum biomarker signatures. Two hundred PD patients and 121 healthy controls underwent structural MRI. Subject-specific cortical similarity networks were constructed using Morphometric INverse Divergence (MIND), and subtypes were identified with HYDRA. Spatial patterns were linked to regional gene expression from the Allen Human Brain Atlas through partial least squares regression, followed by functional and cell-type enrichment analyses. Serum neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) were quantified using single-molecule array assays. No significant MIND differences emerged when PD patients were analysed as a single group. HYDRA identified two subtypes (ARI = 0.85) with divergent cortical organization that only partially overlapped with conventional motor phenotypes. Cluster 1 exhibited temporo-parietal MIND increases associated with synaptic and oligodendroglial signatures, without serum biomarker associations. Cluster 2 showed widespread fronto-cingulate MIND reductions enriched for mitochondrial, lysosomal, and proteostatic pathways, including the KEGG Parkinson’s disease pathway, and these reductions correlated with higher serum NfL and GFAP. These findings reveal two biologically distinct PD subtypes with divergent molecular architecture and systemic neurodegeneration beyond conventional motor phenotyping.
M. Bianco, Camilla Calomino, Maria Celeste Bonacci et al.· International Journal of Mol...· 0 citations
