A Rare Case of Mediastinal Inflammatory Myofibroblastic Tumor
The inflammatory myofibroblastic tumor (IMT) or the inflammatory pseudotumor is a rare benign tumor composed of spindle cells that is known to develop in various locations such as lung, skin, breast, gastrointestinal tract, pancreas, bone, epididymis, peritoneum. Mediastinal localisation of the tumor is very rare. We present the case of a 16 years old female with such pathology.
The patient was admitted into our clinic with a history of pain in the right hemithorax, mild dyspneea and irritative cough. The chest x-ray showed a great ascension of the right hemidiaphragm. Abdominal ultrasound revealed the presence of heterogeneous formations, bulky with liver parenchyma dislocation and fluid collection. The Chest CT examination showed a giant formation in the right hemithorax having right upperdiaphragmatic mass effect on the liver, lower mediastinum and lung parenchyma. A right posterolateral approach was used revealing a giant tumoral formation (14/13/12 cm) originating from the mediastinum. Total surgical ablation was performed.
The postoperative outcome of the patient was good, with no complications and lung reexpansioning. The hospital stay was 7 days. Immunohistochemistry was positive for desmin, VIM, CD 34, CD 68, Ki67, and was diagnosed with inflammatory myofibroblastic tumor. No tumoral recurrence was noticed at the one year and two year follow-up.
The mediastinal inflammatory myofibroblastic tumor is a very rare pathology. It can raise a series of problems such as the preoperative diagnosis, technical problems related to its location. If total surgical ablation is possible the patients have a favorable outcome.