Sinonasal and ventral skull base Inflammatory pseudotumor: A systematic review

Stuti V. Desai, Eleonora F. Spinazzi, Christina H. Fang, Grace Huang, Senja Tomovic, James K. Liu, Soly Baredes, Jean Anderson Eloy

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

Objectives/Hypothesis Inflammatory pseudotumor is a benign idiopathic inflammatory process often misdiagnosed as an infection or neoplasm. This review analyzes all reported cases of sinonasal and ventral skull base inflammatory pseudotumor to date, and provides a framework for evaluation and management of this uncommon condition. Data Sources MEDLINE/PubMed database. Review Methods A search for articles related to sinonasal and ventral skull base inflammatory pseudotumor, along with bibliographies of those articles, was performed. Demographics, presentation, radiographic findings, treatment, follow-up, and outcome were analyzed. Results Thirty-three articles were reviewed, including a total of 87 patients. The most common presenting symptom was vision change (58.6%). Sinonasal and ventral skull base inflammatory pseudotumor was found in the cavernous sinus in 46.0% of cases. The lesion appeared isointense (66.7% of cases) and homogeneously enhancing on T1-weighted magnetic resonance imaging (MRI), whereas it appeared hypointense on T2-weighted MRI in 90.7% of cases. Inflammatory pseudotumor appeared hyperdense on computed tomography in 78.9% of cases. Histopathological analysis of biopsied specimens revealed presence of inflammatory cells (94.4%) and fibrosis (80.3%). Corticosteroids alone were the most common treatment modality (55.2%), resulting in disease-free patients in 22.9% of cases over a median follow-up period of 17.6 months. Surgical management alone was uncommon (8.0%), but showed high success rate (57.1%). Conclusion This review is the most comprehensive analysis of sinonasal and ventral skull base inflammatory pseudotumor to date. Radiologic findings and histopathological analysis are essential for diagnosis. Corticosteroids are the most common treatment modality. Surgery, although uncommon, appears to be an efficacious treatment modality.

Original languageEnglish (US)
Pages (from-to)813-821
Number of pages9
JournalLaryngoscope
Volume125
Issue number4
DOIs
StatePublished - Apr 1 2015
Externally publishedYes

Keywords

  • endoscopic skull base surgery
  • head and neck inflammatory pseudotumor
  • Inflammatory pseudotumor
  • sinonasal
  • sinonasal skull base inflammatory myofibroblastic tumor
  • sinonasal skull base inflammatory pseudotumor
  • skull base inflammatory myofibroblastic tumor
  • skull base surgery
  • ventral skull base
  • ventral skull base pseudotumor

ASJC Scopus subject areas

  • Otorhinolaryngology

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