Elsevier

American Journal of Otolaryngology

Volume 23, Issue 6, November–December 2002, Pages 362-367
American Journal of Otolaryngology

Case Reports
Inflammatory myofibroblastic tumor presenting with tracheal obstruction in a pregnant woman*

https://doi.org/10.1053/ajot.2002.128041Get rights and content

Abstract

Inflammatory myofibroblastic tumor (IMT), also known as inflammatory pseudotumor, is a benign lesion predominantly found in the lung and abdomen. Sporadic cases have been reported in the trunk, genitourinary tract, and extremities as well as in the head and neck. Of critical importance is this entity's correct histopathologic diagnosis that differentiate it from malignant neoplasms such as spindle cell carcinoma and fibrosarcoma, benign tumors such as neurofibroma, and other pseudoneoplastic lesions such as nodular fasciitis. Correct diagnosis is followed by wide local excision to prevent recurrence; however, treatment must be tailored to the location of tumor and the condition of the patient. We present a unique case of IMT of the trachea presenting with acute upper airway obstruction in a pregnant woman. Diagnostic considerations as well as the anesthetic and surgical approach are discussed. (Am J Otolaryngol 2002;23:362-367. Copyright 2002, Elsevier Science (USA). All rights reserved.)

Section snippets

Terminology

Inflammatory myofibroblastic tumor (or IMT) is a controversial entity. Its name evolved from the term inflammatory pseudotumor, which originally was used to describe an apparent pseudosarcomatous proliferation of the lung. The term IMT came into use once the major component of spindle-shaped myofibroblasts became apparent and cytogenetic studies pointed to a neoplastic rather than inflammatory origin.2

Further contributing to the controversy surrounding IMT is the preponderance of tumors in

Conclusion

Inflammatory myofibroblastic tumor is a controversial entity, whose name evolved from further characterization of the inflammatory pseudotumor or plasma cell granuloma of the lung. It is considered a benign, but possibly neoplastic tumor; it is closely related to inflammatory fibrosarcoma and can therefore be locally recurrent.

IMT occurs most commonly in the lung and in children. However, multiple head and neck cases have been documented, and it may occasionally present with airway obstruction

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Cited by (27)

  • Malignant transformation of tracheal inflammatory pseudotumor: A case report

    2009, Journal of Thoracic and Cardiovascular Surgery
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    Difficult cases such as infantile myofibromatosis and rhabdomyosarcoma can be excluded using IHC stains with careful morphologic assessment. Cytokeratin stain, S-100 stain, and HMB45 stain are negative in IPTs.3 The local recurrences, distant metastases, clonal chromosomal aberrations, and even sarcomatous progression described in a few reported cases suggest the malignant potential of IPTs.5

  • Intradural cervical inflammatory pseudotumor mimicking epidural hematoma in a pregnant woman: case report and review of the literature

    2008, Surgical Neurology
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    No inciting factor could be determined in our patient. There is no evidence of documented IPT association with pregnancy; the very few reported cases of IPT in pregnant women [2,21] do not allow any further conclusions concerning the pregnancy implication in the IPT pathogenesis process. In most cases, IPTs are not formally diagnosed until the excised mass is examined histologically and subjected to immunologic staining techniques.

  • Management principles of head and neck cancers during pregnancy: A review and case series

    2008, Oral Oncology
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    Those, which do not resolve may be excised post-partum, after they have organised, to minimise bleeding.34 Clearly, other benign tumours may present during pregnancy, granular cell tumour35 and inflammatory myofibroblastic tumour36 of the trachea, desmoid tumour37 and paraganglioma38 of the larynx, ectopic lingual thyroid,39 and a case of nasopharyngeal angiofibroma40 have all been reported. For any tumour mass it is essential to make an accurate diagnosis to achieve a correct and successful outcome.

  • Pulmonary Processes of Indeterminate Malignant Potential

    2008, Pulmonary Pathology: a Volume in the Series Foundations in Diagnostic Pathology
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*

Address correspondence to Roy Amir, MD, Department of Otolaryngology—Head and Neck Surgery, University of Illinois at Chicago, 1855 W Taylor St, Chicago, IL 60613.

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