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Huang SH, Chuang CC, Huang CC, Jung SM, Lee CC. Diagnosis and Treatment of Inflammatory Pseudotumor with Lower Cranial Nerve Neuropathy by Endoscopic Endonasal Approach: A Systematic Review. Diagnostics (Basel) 2022; 12:2145. [PMID: 36140546 PMCID: PMC9497500 DOI: 10.3390/diagnostics12092145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/29/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Inflammatory pseudotumor (IPT) is a non-neoplastic condition of unknown etiology. IPT with lower cranial nerve (CN IX, X, XI, XII) neuropathies is extremely rare. In this study, we systematically reviewed all previously reported cases regarding the management of IPT with lower cranial nerve neuropathies. We searched the PubMed/MEDLINE database for reports related to IPT with lower cranial nerve neuropathies. A total of six papers with 10 cases met the inclusion criteria (mean age 51.6 years, 70% male). The mean follow-up period was 15.4 months (range: 1-60 months). The most frequent treatment was corticosteroids alone (60%), followed by surgery alone (20%), and multimodal treatment (20%). Corticosteroid therapy was associated with an excellent (100%) response rate at 6 months of follow-up, and half of the patients were in complete remission after 9 months. Both cases who received surgery had persistent neurological deficits. Immediate complete remission of neurological symptoms and resolution on imaging after decompression surgery via an endoscopic endonasal approach (EEA) with corticosteroids was demonstrated in our representative case. This review suggests that EEA is a preferred method for diagnosis and treatment, a promising approach associated with favorable outcomes, and a viable first-line treatment for selected cases, followed by multimodal therapy.
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Affiliation(s)
- Sheng-Han Huang
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 33382, Taiwan
| | - Chi-Cheng Chuang
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 33382, Taiwan
| | - Chien-Chia Huang
- Division of Rhinology, Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan 33382, Taiwan
- School of Medicine, Chang Gung University, Taoyuan 33301, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33301, Taiwan
| | - Shih-Ming Jung
- Department of Pathology, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 33382, Taiwan
| | - Cheng-Chi Lee
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University, Taoyuan 33382, Taiwan
- Department of Biomedical Engineering, National Taiwan University, Taipei 10617, Taiwan
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Sherif HAE, Elzawawi ME, Elmageed MA. Role of magnetic resonance in evaluation of nasopharyngeal tumors in adults. MENOUFIA MEDICAL JOURNAL 2022; 35:654. [DOI: 10.4103/1110-2098.352180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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3
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Bonati LH, Brown MM. Carotid Artery Disease. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00022-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Mishra S, Suh CH, Bergmark RW, Jo VY, Miyawaki EK, Schoenfeld JD, Uppaluri R, Guenette JP. Imaging features, therapies, and outcomes of fibrosing inflammatory pseudotumor of the nasopharynx: A systematic review. J Neuroimaging 2021; 32:223-229. [PMID: 34879175 DOI: 10.1111/jon.12953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/12/2021] [Accepted: 11/15/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Fibrosing inflammatory pseudotumor (FIP) of the nasopharynx is a rare nonneoplastic inflammatory lesion that is frequently mistaken for malignancy or infection. It is often misdiagnosed by radiologists as nasopharyngeal carcinoma or lymphoma, resulting in multiple biopsies and delays in diagnosis. The purpose is to understand trends in clinical presentation, imaging findings, treatment modalities, and patient outcomes of nasopharyngeal FIP. METHODS MEDLINE and EMBASE databases were queried for articles related to FIP of the nasopharynx. Articles that described cases of FIP involving the nasopharynx were selected. Studies that described inflammatory pseudotumor of the nasopharynx associated with known distinct pathologic entities were excluded. RESULTS A total of 19 articles describing 37 patients were included. MRI findings were reported in 32 patients. All cases demonstrated avid gadolinium enhancement. T2-weighted imaging characteristics were described or displayed for 21 patients: 95% demonstrated hypointensity compared to surrounding mucosa. Fluorodeoxyglucose (FDG) PET/CT findings were reported for 6 patients, all demonstrating mild FDG avidity. CONCLUSIONS Nasopharyngeal FIP is a histological diagnosis of exclusion that presents with facial pain and, often, cranial neuropathies. Relatively low T2-weighted MRI signal should inform the interpreting neuroradiologist to include FIP as a differential consideration for both the ordering provider and pathologist. Corticosteroid therapy is the most frequently employed therapy and results in partial or complete response in most patients. Radiation therapy and anti-inflammatory medications have also been reported to have potential therapeutic roles.
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Affiliation(s)
- Shruti Mishra
- Department of Radiology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Regan W Bergmark
- Division of Otolaryngology-Head and Neck Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Vickie Y Jo
- Department of Pathology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Edison K Miyawaki
- Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jonathan D Schoenfeld
- Department of Radiation Oncology, Brigham & Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Ravindra Uppaluri
- Division of Otolaryngology-Head and Neck Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jeffrey P Guenette
- Division of Neuroradiology, Brigham & Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
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Chen WB, Zhang B, Liang L, Dong YH, Cai GH, Liang CH, Lan BW, Zhang SX. To predict the radiosensitivity of nasopharyngeal carcinoma using intravoxel incoherent motion MRI at 3.0 T. Oncotarget 2017; 8:53740-53750. [PMID: 28881847 PMCID: PMC5581146 DOI: 10.18632/oncotarget.17367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 04/11/2017] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To investigate intravoxel incoherent motion (IVIM) MRI for evaluating the sensitivity of radiotherapy on nasopharyngeal carcinoma (NPC). RESULTS The reproducibility between intra-observer and inter-observer was relatively good. D (0.72×10-3 mm2/s±0.14 vs. 0.54×10-3 mm2/s±0.23; P < 0.001) and D* (157.92×10-3 mm2/s±15.21 vs. 120.36×10-3 mm2/s±10.22; P < 0.0001) were significantly higher in effective group than poor-effective group, whereas the difference of f (18.79%±2.51 vs. 16.47%±1.51) and ADC (1.21×10-3 mm2/s±0.11 vs. 1.33×10-3 mm2/s±0.23) could not reach statistical significant between the 2 groups (P > 0.05). CONCLUSIONS IVIM may be potentially useful in assessing the radiosensitivity of NPC. The higher D value combining with higher D* value might indicate the more radiosensitive of NPC, and increased D* might reflect increased blood vessel generation and parenchymal perfusion in NPC. MATERIALS AND METHODS Sixty consecutive patients (20 female, range, 27-83 years, mean age, 52 years) newly diagnosed NPC in the stage of T3 or T4 were enrolled. Forty-two of them were divided into effective group clinically after a standard radiotherapy according to the RECIST criteria. IVIM with 13 b-values (range, 0-800 s/mm2) and general MRI were performed at 3.0T MR scanner before and after radiotherapy. The parameters of IVIM including perfusion fraction (f), perfusion-related diffusion (D*), pure molecular diffusion (D) and apparent diffusion coefficient (ADC) were calculated. Two radiologists major in MRI diagnose analyzed all images independently and placed regions of interest (ROIs). Intra-class correlation coefficient (ICC) was used to evaluate intra-observer and inter-observer agreement. And Mann-Whitney test was used to assess the differences between the two groups.
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Affiliation(s)
- Wen Bo Chen
- Department of Radiology, HuiZhou Municipal Central Hospital, Huizhou, Guangdong, P.R. China
| | - Bin Zhang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
- Southern Medical University, Guangzhou, Guangdong, P.R. China
| | - Long Liang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
| | - Yu Hao Dong
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
- Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Guan Hui Cai
- Department of Radiology, HuiZhou Municipal Central Hospital, Huizhou, Guangdong, P.R. China
| | - Chang Hong Liang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
| | - Bo Wen Lan
- Department of Radiology, HuiZhou Municipal Central Hospital, Huizhou, Guangdong, P.R. China
| | - Shui Xing Zhang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, Guangzhou, Guangdong, P.R. China
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Jung HN, Kim HJ, Kim YK, Song M, Kim HY, Park KM, Cha J, Kim ST. Discrepant lesion size estimated on T1- and fat-suppressed T2-weighted MRI: diagnostic value for differentiation between inflammatory pseudotumor and carcinoma of the nasopharynx. Diagn Interv Radiol 2017; 23:199-205. [PMID: 28420597 DOI: 10.5152/dir.2017.16241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Nasopharyngeal inflammatory pseudotumor (NIPT) is hard to differentiate from infiltrating nasopharyngeal carcinoma (NPC) on conventional magnetic resonance imaging (MRI). The purpose of this study is to determine whether discrepant lesion sizes estimated on T1- and fat-suppressed T2-weighted images can help distinguish between NIPT and NPC. METHODS We retrospectively reviewed MRI data of histologically proven 14 NIPTs and 18 infiltrating NPCs. We measured the area of the lesion on contrast-enhanced T1-weighted, unenhanced T1-weighted, and fat-suppressed T2-weighted images by placing the largest possible polygonal region-of-interest within the lesion at the same level. Using lesion size measured on contrast-enhanced T1-weighted image as the reference, we calculated and compared area ratio of T1 (ART1) and area ratio of T2 (ART2) between NIPTs and NPCs. For validation, we also undertook a double-blinded study by two reviewers and assessed the diagnostic performance and interobserver agreement. RESULTS For NIPTs, ART2 (median, 0.48; range, 0.18-0.97) was statistically significantly less than ART1 (median, 1.01; range, 0.80-1.99), while these values were not significantly different for NPCs. The interobserver agreement in differentiating between NIPT and NPC was good, with a sensitivity of 93% and a specificity of 83%-94%. CONCLUSION In contrast to NPCs, NIPTs appear smaller on fat-suppressed T2-weighted images than on T1-weighted images. This discrepancy in the lesion size estimated on T1-weighted and fat-suppressed T2-weighted images may provide a simple and consistent way to differentiate between NIPTs and NPCs on conventional MRI.
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Affiliation(s)
- Hye Na Jung
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Abstract
OBJECTIVE To describe the presentation, treatment, and outcome of inflammatory pseudotumors (IPs) of the skull base. DATA SOURCES English-language articles in PubMed, Web of Science, and EMBASE from earliest available through April 2014. STUDY SELECTION Articles were identified using a keyword search for "inflammatory pseudotumor," "inflammatory myofibroblastoma," or "plasma cell granuloma," including a keyword localizing to the skull base. DATA EXTRACTION One hundred papers with 157 cases met inclusion criteria. History, tumor site, initial and subsequent treatment, outcomes, and complications were extracted. Student t test, z test, and analysis of variance were used to analyze demographics, symptoms, sites involved, and outcomes. Odds ratios for site versus initial treatment were calculated. DATA SYNTHESIS At diagnosis, average patient age was 41 years. Approximately 70% of lesions primarily involved the anterior skull base, 29% the lateral skull base, and 1.2% the occiput. The most common initial treatments were steroids (44%), surgery (28%), and surgery with steroids (16%). Anterior lesions were 55.8 times more likely than lateral lesions to be treated initially with steroids (CI, 14.7-212). Seventy-six percent of patients had stable or resolved symptoms after a single course of treatment. CONCLUSION Diagnosis of skull base IP requires ruling out other aggressive pathologies, such as malignancy and infection, and maintaining a high index of suspicion. Surgery is favored for lesions that can be removed in toto with minimal morbidity, as well as steroids for those sites where anatomy limits complete resection, such as within the orbit, cavernous sinus, or brain. An option for larger lesions involving vital anatomy is debulking, followed by postoperative steroids.
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Desai SV, Spinazzi EF, Fang CH, Huang G, Tomovic S, Liu JK, Baredes S, Eloy JA. Sinonasal and ventral skull base inflammatory pseudotumor: a systematic review. Laryngoscope 2014; 125:813-21. [PMID: 25376630 DOI: 10.1002/lary.24993] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/26/2014] [Accepted: 10/01/2014] [Indexed: 11/09/2022]
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.
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Affiliation(s)
- Stuti V Desai
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
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10
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Brea Álvarez B, Tuñón Gómez M. Diseminación perineural en tumores de cabeza y cuello. RADIOLOGIA 2014; 56:400-12. [DOI: 10.1016/j.rx.2014.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Revised: 03/20/2014] [Accepted: 04/13/2014] [Indexed: 01/08/2023]
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Zhang SX, Jia QJ, Zhang ZP, Liang CH, Chen WB, Qiu QH, Li H. Intravoxel incoherent motion MRI: emerging applications for nasopharyngeal carcinoma at the primary site. Eur Radiol 2014; 24:1998-2004. [PMID: 24838795 PMCID: PMC4082649 DOI: 10.1007/s00330-014-3203-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 03/14/2014] [Accepted: 04/24/2014] [Indexed: 01/02/2023]
Abstract
Objectives We compared pure molecular diffusion (D), perfusion-related diffusion (D*), perfusion fraction (f) and apparent diffusion coefficient (ADC) based on intravoxel incoherent motion (IVIM) theory in patients with nasopharyngeal carcinoma (NPC). Methods Sixty-five consecutive patients (48 men) with suspected NPC were examined using a 3.0-T MR system. Diffusion-weighted imaging (DWI) was performed with 13 b values (range, 0–800 s/mm2). We regarded the result of endoscopy and biopsy as the gold standard for detection. D, D* and f were compared between patients with primary NPC and enlarged adenoids. Results IVIM DWI was successful in 37 of 40 NPC and 23 of 25 enlarged adenoids cases. D (P = 0.001) and f (P < 0.0001) were significantly lower in patients with NPC than in patients with enlarged adenoids, whereas D* was significantly higher (P < 0.0001). However, the ADC was not significantly different between the two groups (P > 0.05). The area under the ROC curve (AUC) for D was 0.849 and was significantly larger than that for ADC (P < 0.05). Conclusions IVIM DWI is a feasible technique for investigating primary NPC. D was significantly decreased in primary NPC, and increased D* reflected increased blood vessel generation and parenchymal perfusion in primary NPC. Key Points • Intravoxel incoherent motion (IVIM) analysis permits separate quantification of diffusion and perfusion. • IVIM DWI is a feasible technique for investigating primary NPC. • IVIM suggests that primary NPC tissue voxels exhibit both perfusion and diffusion.
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Affiliation(s)
- Shui-xing Zhang
- Department of Radiology, Guangdong Academy of Medical Sciences/Guangdong General Hospital, No. 106 Zhongshan Er Road, 510080, Guangzhou, Guangdong Prov., People's Republic of China
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Gao F, Zhong R, Li GH, Zhang WD. Computed tomography and magnetic resonance imaging findings of inflammatory myofibroblastic tumors of the head and neck. Acta Radiol 2014; 55:434-40. [PMID: 23966365 DOI: 10.1177/0284185113500165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) is a rare tumor of mesenchymal origin that commonly occurs in the lung. Because of its non-specific clinical and imaging features, IMT is often misdiagnosed as a malignant tumor. There have been few imaging reports on IMT of the head and neck. PURPOSE To analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of inflammatory myofibroblastic tumors (IMTs) of the head and neck. MATERIAL AND METHODS Six patients with IMTs of the head and neck confirmed by histopathologic examination were analyzed retrospectively. RESULTS The mean patient age was 40 years. The tumor locations in the six patients were as follows: left bridge of the nose (one), right infratemporal fossa (two), and left parotid gland (three). Three patients who underwent CT all had soft tissue masses or nodules and no calcification. Bridge of the nose tumor showed a homogeneous isodense nodule and mild homogeneous enhancement. Infratemporal fossa tumor showed a homogeneous low density mass and intermediate homogeneous enhancement. Left parotid gland tumor showed a heterogeneous, mostly low density mass, and intermediate heterogeneous enhancement. T1-weighted images of the parotid gland tumors were hypointense; the infratemporal fossa tumor was isointense. T2-weighted images were mildly hypointense and of mixed hypo- and isointensity in the two parotid gland tumors; the infratemporal fossa tumor was homogeneously mildly hypointense. Heterogeneous intermediate enhancement was demonstrated in one parotid gland and the infratemporal fossa patients and mild homogeneous enhancement in another parotid gland patient. CONCLUSION The imaging features of IMTs of the head and neck are non-specific. An ill-defined, aggressive mass and variable enhancement on CT and MRI may suggest the diagnosis of IMT. IMT should be included in the differential diagnosis of regional tumors.
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Affiliation(s)
- Fei Gao
- State Key Laboratory of Oncology in South China, Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Rui Zhong
- State Key Laboratory of Oncology in South China, Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Guo-hong Li
- State Key Laboratory of Oncology in South China, Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Wei-dong Zhang
- State Key Laboratory of Oncology in South China, Department of Radiology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, PR China
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Li J, Yun W, Qin J, Zhao J, Liu X, Wu J, Ji M, Tang J. Inflammatory myofibroblastic tumor of the breast coexisting with breast cancer: a case report. Breast Care (Basel) 2014; 8:290-2. [PMID: 24415982 DOI: 10.1159/000354250] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The inflammatory myofibroblastic tumor (IMT) is an uncommon low-risk lesion with only a few cases described in the literature. CASE REPORT Here, we report a unique case of an IMT coexisting with breast cancer. Modified radical mastectomy was performed, followed by TAC chemotherapy (taxotere, adriamycin and cyclophosphamide). At the 2-year follow-up, the patient continues to be disease free. CONCLUSION At the preoperative stage, definitive diagnoses of masses are extremely difficult; surgery is advised only after the diagnosis is confirmed by pathological examination.
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Affiliation(s)
- Jian Li
- Cancer Hospital of Jiangsu Province, Nanjing Medical University, China
| | - Wen Yun
- Cancer Hospital of Jiangsu Province, Nanjing Medical University, China
| | - Jianwei Qin
- Cancer Hospital of Jiangsu Province, Nanjing Medical University, China
| | - Jianhua Zhao
- Clinical Laboratory Center of Jiangsu Province, Nanjing, Affiliated Hospital of Zhangjiagang City, Nanjing Medical University, China
| | - Xuemin Liu
- Department of General Surgery, Affiliated Hospital of Zhangjiagang City, Nanjing Medical University, China
| | - Jianzhong Wu
- Cancer Hospital of Jiangsu Province, Nanjing Medical University, China
| | - Minghua Ji
- Cancer Hospital of Jiangsu Province, Nanjing Medical University, China
| | - Jinhai Tang
- Cancer Hospital of Jiangsu Province, Nanjing Medical University, China
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Gadde J, Franck B, Liu X, Teixido M, Rizk H. Inflammatory pseudotumor of the nasopharynx with spread along the trigeminal nerve. Am J Otolaryngol 2013; 34:252-4. [PMID: 23369511 DOI: 10.1016/j.amjoto.2012.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 11/16/2012] [Indexed: 10/27/2022]
Abstract
Inflammatory pseudotumor of the nasopharynx is a rare diagnosis that is often misinterpreted as carcinoma or lymphoma. It has been referred to as a tumefactive fibroinflammatory lesion, idiopathic pseudotumor, and fibrosing inflammatory pseudotumor. We present a rare case of a 40-year-old African American female from Kenya with inflammatory pseudotumor of the nasopharynx with perineural spread of disease along the trigeminal nerve to discuss the diagnosis and treatment of such an uncommon entity.
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Xiao C, Wang L, Jiao Y, Sun K, Qin S, Xu X, Guo J, Zhou J. Long-term results of concurrent chemoradiotherapy for T3/T4 locally advanced nasopharyngeal carcinoma. Mol Clin Oncol 2013; 1:507-510. [PMID: 24649201 DOI: 10.3892/mco.2013.75] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 01/24/2013] [Indexed: 11/05/2022] Open
Abstract
Nasopharyngeal carcinoma (NPC) is one of the most commonly diagnosed head and neck malignancies. This study investigated the outcome of locally advanced NPC patients on concurrent intensity-modulated radiation therapy (IMRT) and chemotherapy with docetaxel, cisplatin and 5-fluorouracil (TPF). A total of 226 patients with locally advanced NPC received IMRT, with a total dose of 65-70 Gy and concurrent chemotherapy, with 2 cycles of TPF administered during radiotherapy, between March, 2005 and March, 2007. An additional 2 to 4 cycles of chemotherapy were administered every 21 days following radiotherapy. With a median follow-up time of 35 months (range, 7-60), the 5-year overall survival (OS) rate was 81.4%, with 93.6 and 75.0% for T3 and T4 lesions, respectively, (P=0.001). The 5-year progression-free survival (PFS) was 50.4%, with 66.7 and 46.9% for T3 and T4 lesions, respectively (P<0.001). T-classification was a significant prognostic factor for PFS and OS. The subgroup analysis revealed that pterygopalatine fossa invasion was associated with a significantly lower 5-year PFS (P=0.001) and OS (P=0.002), foramen rotundum invasion was associated with a significantly lower 5-year PFS (P<0.001) and OS (P=0.004), foramen ovale invasion was associated with a significantly lower 5-year PFS (P=0.013) and OS (P=0.024) and foramen lacerum and cavernous sinus invasion were associated with a significantly lower 5-year PFS (P<0.001 and P<0.001, respectively). Concurrent chemoradiotherapy is an advocated regimen for patients with locally advanced NPC, since it exhibits satisfactory 5-year PFS and OS rates. Our results suggest that the estimation of invasive range may identify a subgroup of patients with a higher risk of locoregional failure who may be better candidates for this treatment strategy.
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Affiliation(s)
- Can Xiao
- Departments of Stomatology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215006
| | - Lili Wang
- Radiation Oncology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215006
| | - Yang Jiao
- School of Radiation Medicine and Protection, Medical College of Soochow University, Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Kekang Sun
- School of Radiation Medicine and Protection, Medical College of Soochow University, Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Songbing Qin
- Radiation Oncology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215006
| | - Xiaoting Xu
- Radiation Oncology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215006
| | - Jian Guo
- Radiation Oncology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215006
| | - Juying Zhou
- Radiation Oncology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, Jiangsu 215006
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Lo Casto A, Spataro R, Purpura P, La Bella V. Unilateral laryngeal and hypoglossal paralysis (Tapia's syndrome) in a patient with an inflammatory pseudotumor of the neck. Clin Neurol Neurosurg 2012; 115:1499-501. [PMID: 23265562 DOI: 10.1016/j.clineuro.2012.11.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 11/25/2012] [Indexed: 12/15/2022]
Affiliation(s)
- Antonio Lo Casto
- Department of Radiological Sciences, DIBIMEF, University of Palermo, 90129 Palermo, Italy
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Abstract
OBJECTIVE This article reviews the MRI and CT of nasopharyngeal carcinoma. Extension of nasopharyngeal tumors, especially into the skull base and the deep facial spaces, is well illustrated on imaging. Assessment of retropharyngeal and cervical lymphadenopathy is important for treatment planning. MRI is commonly used for monitoring patients after therapy. CONCLUSION Imaging can detect effect of radiation on surrounding structures. The imaging findings that help to differentiate nasopharyngeal carcinoma from simulating lesions are discussed.
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Huang B, Liu HJ, Liang CH. Inflammatory pseudotumor of the skull base involving fissura petrooccipitalis: a rare case with challenging diagnosis. SKULL BASE REPORTS 2011; 1:105-10. [PMID: 23984211 PMCID: PMC3743602 DOI: 10.1055/s-0031-1280739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 02/10/2011] [Indexed: 11/16/2022]
Abstract
Inflammatory pseudotumor (IPT) is a benign entity that may present as a solid mass mimicking a malignant neoplasm. Histologically, they are composed of varying proportions of myofibroblastic spindle cells, lymphocytes, and plasma cells. Skull base IPT is rare and usually occurs in adults with no sex predilection. The skull base IPT typically presents with headache, and/or cranial nerve palsy. There is no consensus regarding treatment of skull base IPT due to its rarity. Surgical resection and corticosteroid therapy have generally been used. The preoperative diagnosis of skull base IPT is usually difficult due to its nonspecific clinical and radiologic features. We report a case of a 42-year-old woman with IPT originating from the skull base. To our knowledge, this is the first case of IPT invading fissura petrooccipitalis. When a mass in the skull base appears hypointense on T2-weighted imaging with aggressive growth and bony destruction, IPT should be considered in the differential diagnosis.
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Affiliation(s)
- Biao Huang
- Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou, Guangdong, China
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2011; 19:138-41. [PMID: 21637039 DOI: 10.1097/moo.0b013e328345326d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mohr J, Mast H. Carotid Artery Disease. Stroke 2011. [DOI: 10.1016/b978-1-4160-5478-8.10022-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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