Treatment of inflammatory myofibroblastic tumor of the chest: the extent of resection.

Abstract

Owing to the rarity of inflammatory myofibroblastic tumor, its pathology and clinical course are poorly understood. We performed a retrospective chart review of patients diagnosed with inflammatory myofibroblastic tumor in the chest who underwent surgical resection. From 1995 to 2006, 15 patients (10 males and 5 females) underwent surgical procedures owing to inflammatory myofibroblastic tumors. The mean age of these patients was 31.3 years (range, 7 months to 61 years). Among them, 13 patients (86.7%) presented with respiratory symptoms such as cough, dyspnea, and hemoptysis. Seven patients presented with the tumor located in the lung parenchyma, 4 in the trachea, 2 in the main bronchus, 1 in the segmental bronchus, and 1 in the chest wall. The diagnosis was confirmed before surgery for only 1 patient (6.3%). The types of operations performed included lobectomies for 4 patients, wedge resections using video-assisted thoracic surgery for 4 patients, tracheal/bronchial resections with end-to-end anastomoses for 6 patients, and chest wall resection for 1 patient. Only 2 patients received adjuvant radiation therapy. We followed up with all patients postoperatively for a mean of 33.3 months (range, 1.2 months to 8.4 years). Fourteen patients were free of local recurrence or distant metastasis during the follow-up period. Inflammatory myofibroblastic tumor usually requires surgical resection for both proper diagnosis and adequate treatment. Complete resection and achieving negative margins leads to excellent outcome.