Inflammatory pseudotumors of the lung in children: Conservative or aggressive approach?

Abstract

Background Inflammatory pseudotumors (inflammatory myofibroblastic tumors) of the lung are myofibroblastic lesions of controversial nosology. The concept that these are benign lesions has been recently questioned given their capacity for local invasion and recurrence. Procedure and Results. We observed five children with inflammatory pseudotumors of the lung in whom the tumor was resected using the most limited excision possible. Unusually, in all five cases the tumor was localized in the right upper lobe: Three were parenchymal, and the others involved the bronchus. The three parenchymal masses underwent wedge resection, whereas the two bronchial lesions required excision followed by a bronchoplasty and an upper lobectomy, respectively. In all, the pathology showed a complete resection, and the patients had uneventful recoveries. Follow‐ups, including CT and bronchoscopies, ranged from 4 to 8 years (mean of 6.4 years) with no signs of recurrence. Conclusions. Our limited experience supports the idea that excisional surgery is the treatment of choice for inflammatory pseudotumors of the lung. Such excisions, both diagnostic and curative, carry minimal risks and avoid unnecessary mutilation. Closely monitored follow‐up is mandatory, as the natural history of this lesion is not yet well understood. Med. Pediatr. Oncol. 31:100–104, 1998. © 1998 Wiley‐Liss, Inc.

Pulmonary Inflammatory Myofibroblastic Tumor in Children: A Case Report and Brief Review of Literature

“…The most appropriate surgical approach (such as use of the wedge resection, lobectomy, and pneumonectomy) depends on the specific dimension and tumor localization, its relationship with the surrounding structures and the surgical equipment experience ( 36 ).…”

Pulmonary Inflammatory Pseudotumor (Inflammatory Myofibroblastic Tumor)

“…19 The prognosis of patients with completely resected inflammatory pseudotumors is excellent: 78% to 100% of patients were in complete remission after an average follow-up of 3.3 years after surgical resection. 14,17,20 Intrathoracic recurrence was seen in 5% of cases.…”

Successful treatment of unresectable inflammatory pseudotumor of the lung with COX‐2 inhibitor

“…2 The current treatment approach to inflammatory pseudotumors of the lung is total resection of the lung lesion, resulting in total cure with minimal risk of recurrence. 3 Although total excision is preferred, it may not be possible for large inflammatory pseudotumors of the lung, for which complete removal of the mass requires a drastic pneumonectomy. For this category of large inflammatory pseudotumors of the lung, treatment options remain limited.…”