A Case of Endobronchial Inflammatory Myofibroblastic Tumor Treated with Polypectomy Using Endoscopic Electrosurgery with a High-frequency Snare

Abstract

Background. Inflammatory myofibroblastic tumor (IMT) is a rare tumor defined as a distinctive lesion composed of a myofibroblastic spindle cell proliferation accompanied by inflammatory infiltrates. We resected an endobronchial polypoid IMT using a high-frequency electrosurgical snare. Case. A 56-year-old man complained of cough, wheezing and bloody sputum. Chest computed tomography revealed an endobronchial tumor in the right main bronchus, and fluorine-18 fluorodeoxyglucose-positron emission tomography of the tumor showed an abnormal accumulation with a maximum standardized uptake value of 34.1, suggesting malignant potential. He was referred to our hospital for a further examination and treatment. Bronchoscopy showed a polypoid tumor arising from the cartilage portion of the right main bronchus. Endobronchial polypectomy of the tumor was performed using an electrosurgical snare with a high-frequency to generate heat. A histopathological examination of the tumor showed the proliferation of spindle cells with inflammatory infiltrates. On immunohistochemical staining, the tumor cells were positive for vimentin and anaplastic lymphoma kinase. After a month of endoscopic polypectomy, we performed coagulation using argon plasma coagulation at the surgical margin. Follow-up bronchoscopy showed no sign of recurrence after 16 months of treatment. Conclusion. Endoscopic polypectomy by electrosurgery with a high-frequency snare may be a useful method of treating endobronchial IMT.