A case of pulmonary inflammatory myofibroblastic tumor treated with bronchoscopic therapy plus lobectomy

Accurate diagnosis of pulmonary inflammatory myofibroblastic tumor by imaging technology before operation: A case report

RATIONALE

Pulmonary inflammatory myofibroblastic tumor (IMT) is a rare borderline tumor, which has the potential of malignant including invasion of surrounding tissues, distant metastasis and recurrence. However, the preoperative diagnosis is difficult and it can also be difficult to distinguish from malignancy in small tissue samples. Preoperative accurate diagnosis has important clinical significance for patients to choose treatment measures and improve the quality of rehabilitation. We was examined by computed tomography (CT) plain scan plus enhanced scan, magnetic resonance diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) imaging technology in an adult female, compared with lung cancer and pulmonary cryptococcus infection for diagnosis of pulmonary IMT.

PATIENT CONCERNS

A 32-year-old female patient was admitted to the hospital "physical examination revealed nodules in the right upper lung for 1 week".

DIAGNOSES

The patient was diagnosed with Pulmonary inflammatory myofibroblastic tumor.

INTERVENTIONS

Single-port thoracoscopic lobectomy was performed after multidisciplinary consultation.

OUTCOMES

DWI and ADC improves the accuracy of preoperative diagnosis and well guides the formulation of treatment measures. The combined CT, DWI, and ADC magnetic resonance imaging technology has more important significance in the diagnosis and differential diagnosis of IMT and lung malignant tumors.

LESSONS

Although accurate preoperative diagnosis of pulmonary IMT is difficult. Chest CT examination combined with DWI and ADC imaging technology has high clinical significance for the diagnosis of IMT.

A Rare Case of Incidentally Diagnosed Pulmonary Inflammatory Myofibroblastic Tumour with Dramatic Response to Crizotinib in a Postpartum Woman

Introduction

Inflammatory myofibroblastic tumours are rare neoplasms which most commonly affect children and young adults. With an intermediate malignant potential, they are typically detected in the abdomen, lung, mediastinum, head and neck, gastrointestinal tract, and genitourinary tract.

Case description

We describe the case of a 33-year-old postpartum woman incidentally diagnosed with a pulmonary inflammatory myofibroblastic tumour following complaints of poorly controlled hypertension a week after caesarean section. She was ALK-negative and received an ALK inhibitor with complete resolution of the lesion. A ROS1-TFG fusion confirmed the diagnosis of an inflammatory myofibroblastic tumour after CT-guided fine needle aspiration.

Discussion

This case highlights an uncommon presentation posing a diagnostic and therapeutic challenge and the potential treatment option of crizotinib.

LEARNING POINTS

Inflammatory myofibroblastic tumour (IMT) is a rarely reported neoplasm arising in the abdominal soft tissues, the lung, mediastinum, head, neck, gastrointestinal tract, and genitourinary tract, with intermediate malignant potential.IMT is definitively diagnosed only after histological examination following surgical biopsy, based on immunohistochemical markers and the molecular characteristics of the tumour, but small biopsies may have a role in a large lesion.IMT did not cause any complications during gestation.Therapeutic approaches include surgical resection and chemotherapy, including with crizotinib, an ALK tyrosine kinase inhibitor.

First report of an adult female patient with endobronchial inflammatory myofibroblastic tumor in Taiwan: A case report

An inflammatory myofibroblastic tumor (IMT) of the respiratory system is an uncommon disease. In Taiwan, there is a lack of previous studies on tracheobronchial IMT. The tumor is characterized by overexpression of anaplastic lymphoma receptor tyrosine kinase (ALK)‐1. Surgical resection is the standard treatment of choice nowadays.