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Massive Hemorrhage Following Spontaneous Mediastinal Inflammatory Myofibroblastic Tumor Rupture: A Case Report
Sophia B Bellegarde1,2, Vanessa Gibson3, Shahriyour Andaz3
1Pathology and Laboratory Medicine, American University of Antigua, St. John's, ATG.
Cureus
|September 26, 2023
Summary
A ruptured inflammatory myofibroblastic tumor (IMT) caused a large hemothorax in a hypertensive patient. Surgical resection resolved symptoms, highlighting IMT as a rare but serious cause of mediastinal emergencies.
Area of Science:
- Thoracic Surgery
- Oncology
- Diagnostic Imaging
Background:
- A 45-year-old male presented with hypertensive emergency and concerning symptoms including chest discomfort, shortness of breath, and abdominal pain.
- Initial evaluation included computed tomography (CT) and magnetic resonance imaging (MRI) scans.
Observation:
- CT revealed a posterior mediastinal mass. MRI showed a non-enhancing mass potentially compressing the esophagus and airway.
- Thoracoscopy identified a large hemothorax caused by a ruptured inflammatory myofibroblastic tumor (IMT).
Findings:
- A significant hemothorax with fresh and clotted blood was discovered.
- Surgical intervention via right thoracotomy successfully removed the mass and drained the hemothorax.
Implications:
- This case underscores the importance of considering IMT in the differential diagnosis of mediastinal masses, especially when presenting with acute hemothorax.
- Prompt surgical management of ruptured IMT can lead to complete resolution of symptoms and favorable patient outcomes.
