Inflammatory pseudotumor and myofibroblastic inflammatory tumor. Diagnostic criteria and prognostic differences

• Published in: Cirugia española (English ed.) 2022-06, Vol.100 (6), p.329-335
• Main Authors: Carrasco Rodríguez, Rommel, García Fontán, Eva María, Blanco Ramos, Montserrat, Magdalena Benavides, Laura Juaneda, Otero Lozano, Daniel, Moldes Rodriguez, Milagros, Cañizares Carretero, Miguel Angel
• Format: Article
• Language: English
• Subjects: Cirugía; Inflammatory myofibroblastic tumor; Inflammatory pseudotumor; Seudotumor inflamatorio; Surgery; Tumor miofibroblástico inflamatorio
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2022.05.012

[Display omitted] Inflammatory pseudotumor (IPT) and inflammatory myofibroblastic tumor (IMT) are two very rare entities that were formerly included in the same category; however, today they are considered two different diseases due to the neoplastic origin of the IMT. Our objective is to share our experience in the management of these two types of tumors that we must take into account in the differential diagnosis of pulmonary masses or nodules. Thirteen patients with a pathological diagnosis of IPT and IMT who underwent surgery between 2008 and 2019 were retrospectively studied. We recorded the pre and postoperative information of each one, as well as the survival analysis. Of the 13 patients, 8 were men and 5 women. The mean age of presentation was 53,5 years. An atypical segmentectomy was performed in 6 patients; a lobectomy was necessary in 6 and a pneumonectomy in 1 case. In all cases a complete resection was achieved. Diagnosis was possible thanks to histology, immunohistochemical (IHQ) and fluorescent in situ hybridization (FISH) techniques determining the expression of IgG4 and the rearrangement of ALK, respectively. After a median follow up of 49 months, we didn’t find any loco-regional or distant recurrence in the patients studied. IPT and IMT are rare tumors with a very good prognostic. The diagnosis of both entities is based mainly on specific anatomopathological techniques. Surgery has, in most cases, both a diagnostic and therapeutic role. El pseudotumor inflamatorio (PTI) y el tumor miofibroblástico inflamatorio (TMI) son dos entidades muy poco frecuentes que se incluían antiguamente en la misma categoría; sin embargo, en la actualidad se consideran dos enfermedades diferentes debido al origen neoplásico del TMI. Nuestro objetivo es compartir nuestra experiencia en el manejo de estos dos tipos de lesiones que debemos tener en cuenta en el diagnóstico diferencial de masas o nódulos pulmonares. Fueron estudiados retrospectivamente 13 pacientes con diagnóstico anatomopatológico de PTI o TMI intervenidos entre los años 2008 y 2019. Registramos la información pre y postoperatoria de cada uno, así como el análisis de supervivencia. De los 13 pacientes, 8 eran varones y 5 mujeres. La media de la edad de presentación fue de 53,5 años. En 6 pacientes se practicó una segmentectomía atípica, en 6 fue necesario realizar una lobectomía y en 1 caso una neumonectomía. En todos los casos se consiguió una resección completa. El diagnóstico fue posible graci