A rare tumor of trachea: Inflammatory myofibroblastic tumor diagnosis and endoscopic treatment

Abstract

Inflammatory myofibroblastic tumors (IMTs) are rare childhood neoplasms, with benign clinical course. Although etiology of IMTs are not clear, recent studies have reported that IMT is a true neoplasm rather than a reactive or inflammatory lesion. IMTs are rarely seen in adults and tracheal involvement is also rare both in adults and also in children. We describe a 16-year old female patient who was misdiagnosed and treated as asthma in another center for a few months and presented with acute respiratory distress due to upper airway obstruction. Computerized tomography (CT) of the chest and rigid bronchoscopy revealed a mass lesion that was nearly totally obliterating tracheal lumen. Bronchoscopic resection was performed under general anesthesia and the final pathological diagnosis was tracheal IMT.

ERS statement: interventional bronchoscopy in children

“…To stop bleeding, argon plasma coagulation is used. In children, cryotherapy has been used in association with argon plasma coagulation for removing a low-grade bronchial mucoepidermoid carcinoma [143] and an inflammatory myofibroblastic tumour [144].…”

Tracheal Inflammatory Myofibroblastoma: A Rare Tumor of the Trachea

“…Due to its non-specific presentation, it is often missed unless direct laryngoscopy or bronchoscopy is done and the lesion is identified. Grossly, the lesion has been described as nodular, polypoid, or pedunculated [4-6]. They tend to be smooth, fleshy and firm in consistency and the size may range from several millimeters to a few centimeters.…”

“…Histopathological identification is crucial in diagnosis as it is often misdiagnosed and confused with other neoplasms even by experienced pathologists owing to its low occurrence and a wide variety of presentation. Typically three histologic patterns are recognized [4-6], including spindle or stellate myofibroblasts with abundant inflammatory cells in myxoid stroma or storiform pattern with compact spindle cells surrounded by inflammatory cells or dense collagen with scare cellular pattern. On immunohistochemistry, IMF is typically positive for muscle-specific actin, smooth muscle actin, vimentin, and desmin, while negative for myogenin, cytokeratin, and S100.…”

Rare airway tumors: an update on current diagnostic and management strategies

“…Furthermore, there is no epidemiological data due to the lack of large prospective or retrospective clinical studies. Through individual review of most up-to-date case reports and reviews of each individual tumor, we present the prevalence of each tumor as percentage of primary pulmonary tumors (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) or as number of reported cases as well as gender predominance, age predominance and associated risk factors, Table 2 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”

“…There are subtle differences in the diagnostic work-up for these tumors depending on the extent of the disease. General summary of the diagnostic tool and associated findings of each tumor is presented below ( Table 3) (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(30)(31)(32)(33)36,38,48,58,59) .…”