Pulmonary inflammatory myofibroblastic tumor: A case report in an adolescent with chest pain

Inflammatory myofibroblastic tumor (IMT) may affect individuals of any age, but have a predilition for children and young adults. IMT has been reported to occur in any organ, most commonly in lung. The incidence of pulmonary IMT varies from 0.04% to 7% of thoracic surgical resection. Patients are often asymptomatic but when symptoms do occur they commonly consist of fever, cough, pain, haemoptysis or weight loss. The true nature of this lesion remains controversial. It can reflect an exaggerated inflammatory response to tissue damage with subsequently pseudotumor formation but it may also be a true neoplastic process. Chest X-ray typically demonstrates a solitary, well-demarcated peripheral lung mass. Cavitation, hilar and mediastinal adenopathy are uncommon. Diagnosis is almost possible after resection of the tumor and immunoistochemical investigations. IMT should be differentiated from malignancies such as low-grade myofibrosarcoma and other tumors. Complete resection and tumor size less than or equal to 3 cm are associated with better survival. Local recurrence or distant metastases are only observed following incomplete resection of the primary lesion. The role of corticosteroids, chemo or radiation therapy is unclear. A 12.6-year-old boy was referred for an auxologic evaluation. He complained sporadic chest pain not related to respiration. Other pulmonary manifestation were not present His chest radiographs, computed tomography scan and magnetic resonance demonstrated a 4 cm x 3 cm mass near to left hilum and left heart border. A left thoracotomy was performed to resect the mass. The biopsy was compatible with a pulmonary inflammatory myofibroblastic tumor. During the 2 years follow-up the patient had not local recurrence.