Head and neck inflammatory pseudotumor: Case series and review of the literature

Neuroradiol J. 2016 Dec;29(6):440-446. doi: 10.1177/1971400916665377. Epub 2016 Sep 20.

Abstract

Inflammatory pseudotumor (IP) is an uncommon idiopathic lesion that often imitates malignancy clinically and radiologically. Inflammatory pseudotumors have been found to occur in various sites but rarely in the head and neck. The histopathology, imaging, and treatment of three unique cases of head and neck inflammatory pseudotumors are described in this case series. Patients in Cases 1 and 2 presented with right level II neck mass and left parotid tail mass, respectively. The patient in Case 3 presented with otalgia, jaw pain and trismus, and a left parapharyngeal space mass. The tumors in Cases 1 and 3 significantly decreased in size with tapered courses of oral corticosteroids. The tumor in Case 2 was surgically excised without disease recurrence. Malignancy must be ruled out with incisional or excisional biopsy. Treatment includes surgical excision, oral corticosteroids, or both. The literature shows that radiotherapy and small-molecule inhibitors may be promising alternatives.

Keywords: Head and neck neoplasms; IgG4 disease; head and neck oncology; inflammatory pseudotumor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antigens, CD / metabolism
  • Female
  • Granuloma, Plasma Cell / complications*
  • Granuloma, Plasma Cell / diagnostic imaging
  • Head / diagnostic imaging
  • Head / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nasopharyngeal Diseases / complications*
  • Nasopharyngeal Diseases / diagnostic imaging
  • Neck / diagnostic imaging
  • Neck / pathology*
  • Orbital Pseudotumor / complications*
  • Orbital Pseudotumor / diagnostic imaging

Substances

  • Antigens, CD