2021 Volume 43 Issue 5 Pages 515-519
Background. Although inflammatory myofibroblastic tumor (IMT) is regarded as a type of inflammatory pseudotumor with a role in the repair mechanism of inflammation, the concept of the tumor has recently shifted to a malignant tumor with the potential for local invasion, recurrence, and metastasis. We herein report a rare case of IMT of the pleura. Case. A 79-year-old man with a history of occupational asbestos exposure was admitted to our hospital with a complaint of dyspnea on exertion. Chest CT revealed left pleural effusion and pleural thickening. Because no malignant findings were detected in the pleural tumor specimen biopsied by thoracoscopy under local anesthesia, he was diagnosed with benign asbestos pleural effusion. During the follow-up period, the left pleural effusion and pleural thickening were exacerbated, and he was referred to our department for rebiopsy. We performed video-assisted thoracoscopic pleural tumor resection under general anesthesia followed by a histopathological examination, which revealed that the tumor was an IMT. Because of massive pleural dissemination in the intrathoracic cavity and the patient's poor physical condition, radical excision was contraindicated. The tumor was ALK-negative, and chemotherapy was not indicated. The patient died approximately 2 months after surgery. No effective treatment was found. Conclusion. Because the diagnosis of pleural IMT by thoracoscopic biopsy under local anesthesia is difficult, early radical resection with the aim of performing diagnostic therapy under general anesthesia is recommended.
