Inflammatory pseudotumor of the cavernous sinus and skull base

McCall, Todd D.; Fassett, Daniel R.; Lyons, George D.; Couldwell, William T.

doi:10.1007/s10143-006-0017-9

Cited by 27 publications

(35 citation statements)

References 74 publications

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“…Meningeal PCG is a rare intracranial disease with few cases reported 1,2 and has been referred to by several names in the literature [2][3][4][5][6] , including inflammatory myofibroblastic tumor, fibrohistiocytoma, xanthomatous pseudotumor 2 , fibroxanthoma, xanthogranuloma 5 and fibroxanthomatous histiocytoma 4 . It occurs in young males (median age, 28 years) and is usually located in the supraand parasellar regions [1][2][3] , even infiltrating the cavernous sinus 2 .…”

Section: Discussionmentioning

confidence: 99%

“…It occurs in young males (median age, 28 years) and is usually located in the supraand parasellar regions [1][2][3] , even infiltrating the cavernous sinus 2 . Contiguous paranasal sinus and intracranial disease has been reported 3 .…”

Section: Discussionmentioning

confidence: 99%

“…The underlying brain can be compressed, with consequent edema. The MRI of meningeal plasma cell granuloma demonstrates a lobulated mass iso to hypointense on T1WI and hypointensity on T2WI, with heterogeneous contrast enhancement [2][3][4] . The low intensity on T2WI may be due to its high fibrosis content and celularity 6 .…”

Section: Discussionmentioning

confidence: 99%

“…The tumor is usually located in the parasellar region, with several cases involving the cerebellum-pontine angles 2,4,5 . It is also described as a diffuse dural thickening, even extending to the cervical canal 2,5 . The involvement of base structures such as the Meckel's cavum, cavernous sinus and internal auditory canal can cause cranial nerve palsy 7 .…”

Section: Discussionmentioning

confidence: 99%

“…Plasma cell granuloma (PCG) are uncommon non-neoplastic masses of unknown etiology, characterized histologically by proliferation of connective tissue with an inflammatory infiltrate of mononuclear elements 1,2 . They occur more commonly in the lung and conducting airways, but can also be seen in other tissues, such as the meninges 3 .…”

Section: Lettermentioning

confidence: 99%

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Intracranial cell plasma granuloma

Brito

Lopes

Chimelli

et al. 2010

Arq. Neuro-Psiquiatr.

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LetterPlasma cell granuloma (PCG) are uncommon non-neoplastic masses of unknown etiology, characterized histologically by proliferation of connective tissue with an inflammatory infiltrate of mononuclear elements 1,2 . They occur more commonly in the lung and conducting airways, but can also be seen in other tissues, such as the meninges 3 . The imaging appearance of meningeal PCG can simulate more common neoplasms, as menigiomas. At computed tomography (CT) scans, the meningeal PCG presents as an extra-axial hyperdense mass with homogeneous contrast enhancement. On the magnetic resonance images (MRI), the tumor is characterized by isointense to hypointense signal on T1 weighted-images (WI) and hypointense signal on T2WI, with intense and homogeneous contrast enhancement 1,2,4 .We report an additional case of meningeal plasma cell granuloma, with emphasis to the differential diagnosis. CaseA 47-year-old man presented with a 1-year history of reduced visual acuity, mainly on the left side, hearing loss, difficulty in walking and urinary retention. The physical examination revealed spastic tetraparesis, ataxia and paresis of VII to XII cranial nerves, beyond left amaurosis, right amblyopia and bilateral hearing loss, worst at right. CT showed a slightly hyperdense and lobulated dural-based mass with intense and homogeneous contrast-enhancement. It was located at the right cerebellum-pontine angle, occupying the basal cisterns, tentorium cerebelli and supra and parasellar regions, compressing the cerebellum, brain stem and aqueduct of Sylvius, resulting in non-communicat- Intracranial cell plasma granuloma GranuLoma pLaSmoCitário intraCranianoDepartments of Radiology and Pathology of the Federal University of Rio de Janeiro, Rio de Janeiro RJ, Brazil: 1 Mestranda do Programa de Pós-Graduação em Medicina; 2 Professora Titular de Patologia; 3 Professor Adjunto de Radiologia. ing hydrocephalus. No bone changes (hyperostosis, permeative and/or destructive lesions) were noticed in the skull base.The MRI corroborated the relation of the lesion with the duramater, and showed a mass with well-defined lobulated margins, iso to low signal intensity on T1-weighted images, low signal intensity on T2-weighted images and homogeneous enhancement after intravenous gadolinium administration (Fig 1 and Fig 2). It occupied the right cerebellum-pontine angle, compressing the brain stem, with probable invasion of both cavernous sinuses. There were multiple other focal masses along the skull base, with partial encasement of vertebral and basilar arteries. The lesions extended to the optic, internal auditory and hypoglossal canals bilaterally. There was a lesion anterior to the medulla oblonga, compressing this structure, with an inferior extension to the anterior aspect of spinal canal.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Lettermentioning

confidence: 99%

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Intracranial cell plasma granuloma

Brito

Lopes

Chimelli

et al. 2010

Arq. Neuro-Psiquiatr.

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Inflammatory Pseudotumor of the Nasopharynx and Skull Base

Chwang

Jain

Narayan

et al. 2012

Arch Otolaryngol Head Neck Surg

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Sinonasal and ventral skull base Inflammatory pseudotumor: A systematic review

et al. 2014

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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. Level of Evidence N/A Laryngoscope, 125:813–821, 2015

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Inflammatory pseudotumor of the cavernous sinus and skull base

Cited by 27 publications

References 74 publications

Intracranial cell plasma granuloma

Intracranial cell plasma granuloma

Inflammatory Pseudotumor of the Nasopharynx and Skull Base

Sinonasal and ventral skull base Inflammatory pseudotumor: A systematic review

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