Published online Feb 16, 2017. doi: 10.12998/wjcc.v5.i2.61
Peer-review started: March 31, 2016
First decision: April 15, 2016
Revised: November 30, 2016
Accepted: December 13, 2016
Article in press: December 14, 2016
Published online: February 16, 2017
Inflammatory pseudotumor (IPT) has always been considered a diagnostic challenge. Its rarity and resemblance to other more common pathological entities imposes that neither clinical nor radiological characteristics can lead to a definitive diagnosis. The surgical excision of the lesion is the ultimate approach for accurate diagnosis and cure. Moreover the true nature of IPT, its origin as a neoplastic entity or an over-reactive inflammatory reaction to an unknown trigger, has been a long debated matter. Surgery remains the treatment of choice. IPT is mostly an indolent disease with minimal morbidity and mortality. Local invasion and metastasis predict a poor prognosis. We hereby present a unique case of pulmonary IPT that was surgically excised, but recurred contralaterally, shortly thereafter. Despite no medical or surgical treatment for ten years, the lesion has remained stable in size, with neither symptoms nor extra-pulmonary manifestations.
Core tip: Inflammatory pseudotumor is considered a diagnostic challenge, with no one-self explained pathophysiology. Over-reactive inflammatory response to various triggering agents or even an entity with malignant potentials represents the two-sided pendulum. Accurate pathological identification lies on adequate tissue acquisition, which often occurs during surgical resection; the preferred treatment approach. Even though both local recurrence and metastasis represent a poor prognosis, its indolent course is not a well-known property, which we do here highlight in our patient with a 10-year follow up, possessing a stable and indolent disease.