A resected case of inflammatory myofibroblastic tumor arising from the apical chest wall

Abstract

An asymptomatic 43-year-old female was admitted to our hospital with an abnormal shadow on her chest X-ray. Close examination revealed a 35 mm right anterior chest wall tumor located in the first intercostal space and she underwent video-assisted thoracoscopic surgery. The tumor adhered to the ribs and was resected with periostea and intercostal muscles. No malignant cell was identified during intraoperative examination and the operation was completed. Pathological diagnosis after the operation was myofibroma. Six months later, she had a relapse in the right apex. The tumor extended from the 1^st to the 4^th rib, suspected to have invaded the subclavian vein. With an anterior approach (median sternotomy, right hemi-collar incision, and 4^th intercostal thoracotomy), she underwent partial resection of the 1^st to the 4^th rib, sternum, right clavicle, and the right upper lobe, and chest wall reconstruction. Histological diagnosis was inflammatory myofibroblastic tumor (IMT). She's been alive for 20 months without any recurrence.