Inflammatory myofibroblastic tumour of cervix: Uncommon pathology in an unlikely location - A literature review

Background: Inflammatory myofibroblastic tumours (IMTs) of the uterine cervix are extremely rare, benign mesenchymal neoplasms, characterized by the proliferation of myofibroblasts within an inflammatory background. IMTs most commonly occur in the lungs and abdomen, and their occurrence in the female genital tract, particularly the uterine cervix, is exceedingly rare. The optimal management of these tumours remains under investigation due to the limited number of reported cases. Objectives: This literature review aims to provide an overview of the clinical presentation, diagnostic challenges and management strategies of uterine cervical IMTs. This review focuses on the roles of histopathology, immunohistochemistry (IHC) and molecular analysis in diagnosing these tumours, and discusses treatment outcomes and follow-up strategies. Methods: A comprehensive review of the literature was conducted using PubMed, Google Scholar and other relevant databases. Relevant case reports and studies published between 2000 and 2024 were included. The primary outcomes assessed were clinical presentation, diagnostic features, treatment modalities and recurrence/ metastasis rates. Results: Eleven reports of IMTs of the uterine cervix were identified in the literature search, and six of these were included in this review. Clinical presentation primarily includes abnormal uterine bleeding (AUB), often with symptoms of menorrhagia and dysmenorrhoea. Imaging studies and histopathological examination play key roles in diagnosis, with IHC markers such as smooth muscle actin, desmin and anaplastic lymphoma kinase (ALK)-1 being used frequently. Surgical resection remains the mainstay of treatment, with some cases also benefiting from targeted therapy for recurrent or metastatic disease. Conclusion: IMTs of the uterine cervix are rare but are increasingly recognized in clinical practice. They are typically benign with a low risk of malignancy, although local recurrence is possible, especially in cases of incomplete resection. Diagnosis relies heavily on histopathological and molecular analysis, with ALK gene rearrangements being an important molecular finding. While surgical excision remains the primary treatment, ongoing research into targeted therapies, including ALK inhibitors, offers promising avenues for management. This review emphasizes the need for long-term follow-up given the potential for recurrence.