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Abelkis E, van Langevelde K, Doeleman T, Groen J, Navas Cañete A. Inflammatory Pseudotumor of the Ulnar Nerve Mimicking a Malignant Peripheral Nerve Sheath Tumor: A Radiologic Puzzle. Semin Musculoskelet Radiol 2024; 28:651-656. [PMID: 39406227 DOI: 10.1055/s-0044-1788578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2024]
Abstract
Inflammatory pseudotumor (IPT) of a peripheral nerve is a rare non-neoplastic tumefactive inflammatory condition, often mimicking malignancy. The etiology of this condition is still unknown. Clinically and radiologically, the lesion can mimic a malignant tumor. This case report represents, as far as we know, the first publication describing the ultrasonography findings and the results of advanced dynamic contrast-enhanced magnetic resonance imaging (MRI) and diffusion-weighted MRI of IPT in a peripheral nerve. Suspicion of this entity on imaging can speed up the definitive diagnosis and potentially avoid overly radical treatment.
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Affiliation(s)
- Eimantas Abelkis
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Radiology, HagaZiekenhuis, The Hague, The Netherlands
| | | | - Thom Doeleman
- Department of Pathology, Leiden University Medical Centre, Leiden, the Netherlands
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Justus Groen
- Department of Neurosurgery, Leiden Nerve Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Ana Navas Cañete
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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Fiacchini G, Cambi C, Tavoni AG, Bruschini L, Castellana R, Dallan I, Berrettini S. Skull-Base Inflammatory Pseudotumor Involving the Trigeminal and Facial Nerves: A Singular Presentation of a Rare Disease. Surg J (N Y) 2020; 6:e33-e36. [PMID: 32133412 PMCID: PMC7054056 DOI: 10.1055/s-0040-1702921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/14/2020] [Indexed: 11/18/2022] Open
Abstract
Inflammatory pseudotumor (IPT) is a rare disease that is often misinterpreted as a lymphoma or carcinoma. It may involve different body regions but most commonly the lungs and the orbital cavity. We report the case of a patient affected by an IPT of the trigeminal and facial nerves. A 69-year-old male presented to our hospital with a right facial palsy arisen suddenly 2 days before. A magnetic resonance imaging (MRI) of the head showed an abnormal mass with homogeneous enhancement involving the deep lobe of the parotid gland, the parapharyngeal space, and the infratemporal fossa, extending along the trigeminal nerve and the facial nerve. The patient was planned for multiple transnasal biopsies in the nasopharynx, the region of the foramen ovale, and the deep lobe of the parotid gland, but the results were inconclusive, with no evidence of a malignant process. We considered the possibility that the lesion could be an IPT, and the patient was treated with prednisone and cyclophosphamide. Three months after the conclusion of the treatment, an MRI showed a complete radiological response.
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Affiliation(s)
- Giacomo Fiacchini
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Christina Cambi
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Antonio Gaetano Tavoni
- Clinical Immunology Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Luca Bruschini
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Roberto Castellana
- Radiology Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Iacopo Dallan
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Stefano Berrettini
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
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