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An Inflammatory Pseudotumor Arising from Pterygopalatine Fossa with Invasion to the Maxillary Sinus and Orbital Cavity.

Yokoi H, Yazawa T, Matsumoto Y, Ikeda T, Fujiwara M, Ohkura Y, Kohno N - Case Rep Otolaryngol (2015)

Bottom Line: CT images showed a neoplastic lesion that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site, and also showed contrast effects.The patient had a lymphoid-predominant lesion that responded to radiotherapy but corticosteroids were not effective.It is important to scrutinize the pathology to avoid unnecessary and mutilating surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.

ABSTRACT
We report a patient who had an inflammatory pseudotumor (IPT) that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site; this is a very rare case. The patient was an 83-year-old woman who suddenly became aware of impairment in the eyesight and visual field of the left eye. CT images showed a neoplastic lesion that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site, and also showed contrast effects. To obtain a definitive diagnosis from histopathological analysis, the lesion was biopsied, and she was diagnosed as the inflammatory pseudotumor with the immunohistochemical study and multiplex polymerase chain reaction-based clonality assays. The patient had a lymphoid-predominant lesion that responded to radiotherapy but corticosteroids were not effective. It is important to scrutinize the pathology to avoid unnecessary and mutilating surgery.

No MeSH data available.


Related in: MedlinePlus

(a) Steroid therapy showed no change in the lesion. (b) Radiotherapy showed almost the entire lesion disappearing.
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fig4: (a) Steroid therapy showed no change in the lesion. (b) Radiotherapy showed almost the entire lesion disappearing.

Mentions: The clinical course after biopsy included steroid pulse therapy according to the following protocol: 1 g of methylprednisolone sodium succinate for 3 days, followed by prednisolone, for which the dosage was gradually reduced from 40 mg to 10 mg and finally to 5 mg. However, no apparent vision recovery was observed during eyesight examination. Subsequently, we decided to administer radiotherapy. The patient received a total of 40 Gy radiotherapy, which was very effective, and her left eye vision recovered with a BCVA of 0.7.The CT images after steroid therapy showed no change in the lesion (Figure 4(a)); however, after radiotherapy, almost the entire lesion disappeared (Figure 4(b)).


An Inflammatory Pseudotumor Arising from Pterygopalatine Fossa with Invasion to the Maxillary Sinus and Orbital Cavity.

Yokoi H, Yazawa T, Matsumoto Y, Ikeda T, Fujiwara M, Ohkura Y, Kohno N - Case Rep Otolaryngol (2015)

(a) Steroid therapy showed no change in the lesion. (b) Radiotherapy showed almost the entire lesion disappearing.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4488552&req=5

fig4: (a) Steroid therapy showed no change in the lesion. (b) Radiotherapy showed almost the entire lesion disappearing.
Mentions: The clinical course after biopsy included steroid pulse therapy according to the following protocol: 1 g of methylprednisolone sodium succinate for 3 days, followed by prednisolone, for which the dosage was gradually reduced from 40 mg to 10 mg and finally to 5 mg. However, no apparent vision recovery was observed during eyesight examination. Subsequently, we decided to administer radiotherapy. The patient received a total of 40 Gy radiotherapy, which was very effective, and her left eye vision recovered with a BCVA of 0.7.The CT images after steroid therapy showed no change in the lesion (Figure 4(a)); however, after radiotherapy, almost the entire lesion disappeared (Figure 4(b)).

Bottom Line: CT images showed a neoplastic lesion that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site, and also showed contrast effects.The patient had a lymphoid-predominant lesion that responded to radiotherapy but corticosteroids were not effective.It is important to scrutinize the pathology to avoid unnecessary and mutilating surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.

ABSTRACT
We report a patient who had an inflammatory pseudotumor (IPT) that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site; this is a very rare case. The patient was an 83-year-old woman who suddenly became aware of impairment in the eyesight and visual field of the left eye. CT images showed a neoplastic lesion that invaded to the maxillary sinus and orbital cavity, with the left pterygopalatine fossa as the principal site, and also showed contrast effects. To obtain a definitive diagnosis from histopathological analysis, the lesion was biopsied, and she was diagnosed as the inflammatory pseudotumor with the immunohistochemical study and multiplex polymerase chain reaction-based clonality assays. The patient had a lymphoid-predominant lesion that responded to radiotherapy but corticosteroids were not effective. It is important to scrutinize the pathology to avoid unnecessary and mutilating surgery.

No MeSH data available.


Related in: MedlinePlus