A fatal multiple-lesion, inflammatory, pseudotumor in the lung: a rare case report

Abstract

An inflammatory pseudotumor is considered a benign form of lesion marked by a proliferation of myofibroblasts with different degrees of inflammatory infiltrates. Pulmonary inflammatory pseudotumors (PIPs) are extremely rare in middle-aged adults. Normally, a PIP has a single lesion, and can be controlled constantly by surgery and drugs. In this paper, we report a case study of a 51-year-old male patient who presented with multiple inflammatory pseudotumors in lungs, thoracic spine, ribs, left humerusl, derived from PIPs throughout his body, which indicated a long disease term and significant recrudescence. After 6 surgeries (a wedge resection of the right lower lobe, a removal of three thoracic vertebral lesions, a removal of left humeral tumor lesion, a right lower lobe resection, local cryoablation of right lung, debridement of left upper-arm osteomyelitis and soft tissue infection), radiotherapy for lesions of left humerus destruction at a total dose of 20 Gy/10 F, and systematic treatments (30 mg prednisone acetate daily for 6 weeks, 50 mg compound cyclophosphamide tablets for 2 weeks; antibiotics, blood transfusions, nutritional support), his symptoms improved but reoccurred. The patient ultimately died of septic shock. Our case report highlights that the progression of a PIP to a malignant form requires further research. A multiple-lesion PIP that does not respond to systemic treatment can be highly dangerous.