CTICasesPleural Inflammatory Myofibroblastic Tumor
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Imaging findings
Chest CT and PET-CT show a very large, aggressive pleural or chest wall mass in a young patient, exhibiting areas of necrosis, calcification, and high FDG-avidity. Chronic periosteal reaction is seen in the underlying rib. Intraoperatively, the mass was noted to be extremely matted and scarred down to the surrounding tissues, rendering it unresectable. Pathology from a debulking procedure confirmed an inflammatory myofibroblastic tumor.
Key takeaways
Inflammatory myofibroblastic tumors are rare mesenchymal neoplasms composed of myofibroblastic spindle cells accompanied by an inflammatory infiltrate of lymphocytes, plasma cells, and histiocytes. Although typically considered of intermediate malignant potential, they can behave in a highly locally aggressive and invasive manner, resulting in dense, matted fibrosis that makes complete surgical resection difficult.
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