Ahn Seha, Moon Youngkyu
Department of Thoracic and Cardiovascular Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, South Korea.
World J Clin Cases. 2024 Jan 16;12(2):425-430. doi: 10.12998/wjcc.v12.i2.425.
Inflammatory myofibroblastic tumors (IMTs) are exceptionally rare neoplasms with intermediate malignant potential. Surgery is the accepted treatment option, aiming for complete resection with clear margins.
A 39-year-old woman presented with a growing solitary pulmonary nodule measuring 2.0 cm in the right upper lobe (RUL) of the lung. The patient under-went a RUL anterior segmentectomy using uniportal video-assisted thoracoscopy. A preliminary tissue diagnosis indicated malignancy; however, it was later revised to an IMTs. Due to the absence of a minor fissure between the right upper and middle lobes, an alternative resection approach was necessary. Therefore, we utilized indocyanine green injection to aid in delineating the intersegmental plane. Following an uneventful recovery, the patient was discharged on the third postoperative day. Thereafter, annual chest tomography scans were scheduled to monitor for potential local recurrence.
This case underscores the challenges in diagnosing and managing IMTs, showing the importance of accurate pathologic assessments and tailored surgical strategies.
炎性肌纤维母细胞瘤(IMTs)是极为罕见的具有中度恶性潜能的肿瘤。手术是公认的治疗选择,目标是实现切缘阴性的完整切除。
一名39岁女性因右肺上叶(RUL)出现一个直径2.0 cm且不断增大的孤立性肺结节而就诊。该患者接受了单孔电视辅助胸腔镜下的RUL前段切除术。初步组织诊断提示为恶性肿瘤;然而,后来修正为IMTs。由于右上叶和中叶之间缺少小裂,需要采用替代切除方法。因此,我们使用吲哚菁绿注射来辅助划定段间平面。术后恢复顺利,患者于术后第三天出院。此后,安排每年进行胸部断层扫描以监测潜在的局部复发情况。
本病例强调了IMTs诊断和管理中的挑战,显示了准确病理评估和量身定制的手术策略的重要性。