Sclerosing Pneumocytoma with a Wax-and-Wane Pattern of Growth: A Case Report on Computed Tomography and Magnetic Resonance Imaging Findings and a Literature Review

Sclerosing pneumocytoma (SP) of the lung is a rare benign neoplasm. Here, we describe an unusual presentation of SP with a wax-and-wane pattern of growth in a 47-year-old woman. Tumor diameter decreased over a 3-year follow-up period and then increased on serial follow-up computed tomography scans. The mass showed high signal intensity on both T1- and T2-weighted chest magnetic resonance imaging (MRI) and early enhancement with a plateau on dynamic MRI. We speculate that intratumoral bleeding and resorption processes accounted for the changes in tumor size.

Hemangioma pulmonar esclerosante / Pulmonary sclerosing hemangioma

O hemangioma pulmonar esclerosante é um tumor pouco freqüente, que se manifesta como nódulo pulmonar solitário. Entretanto, o seu comportamento biológico ainda não está definido adequadamente. O diagnóstico e a evolução dessas lesões são dificultados pelos achados radiológicos inespecíficos e a dificuldade de interpretação das biópsias de congelação. Os autores descrevem um caso em que o tumor foi completamente retirado com a lobectomia, e o diagnóstico histopatológico definitivo foi de hemangioma esclerosante de pulmão. A ressecção em cunha é realizada na maioria dos casos; porém, quando o diagnóstico não é definido no intra-operatório, é recomendada ressecção mais extensa e linfadenectomia sistemática. Mais estudos são necessários para avaliar a extensão da doença, apesar das metástases não alterarem o excelente prognóstico.

Lung sclerosing hemangioma is an uncommon tumor that presents as a solitary asymptomatic nodule. However, the biologic behavior of this tumor has not yet been characterized adequately. Diagnostic evaluation of this lesion is a diagnostic challenge due to the nonspecific radiological findings, potential intraoperative dilemmas like difficult frozen section interpretation.We describe a case of lung sclerosing hemangioma. The tumour was completely removed by lobectomy and the definitive biopsy was informed as a lung sclerosing hemangioma. Generally, wedge resection is justified in the majority of cases, but in cases of uncertain intraoperative diagnosis, extensive resection with systematic lymphadenectomy is recommended.More studies are needed to evaluate extension of this disease, despite metastasis does not seem to change theexcellent prognosis.