Abstract
Abstract Inflammatory myofibroblastic tumors (IMT) are spindle cell neoplasms with myofibroblastic differentiation and inflammatory infiltration that are typically benign in presentation but can present aggressively in rare circumstances. We herein report the case of a 17-year-old Jamaican female with metastatic IMT who initially presented to the emergency department in her hometown of Kingston, Jamaica with severe chest tightness. Due to severe hemoptysis in the emergency department, the patient underwent emergent right upper and middle lobectomy after initial radiological work-up showing a mixed density mass within the right upper lobe. Initial pathology done by a general pathologist interpreted immunohistochemical findings to be suggestive of histiocytic sarcoma. However, follow-up analysis by a sarcoma-specialized pathologist at our institution resulted in an interpretation of inflammatory myofibroblastic tumor. While typical treatment consists of surgical removal and chemotherapy, the aggressive presentation of this patient's disease necessitated combinations of targeted therapies such as ALK inhibitors with immunotherapy