Sphenoid wing inflammatory pseudotumor mimicking a clinoidal meningioma: case report and review of the literature.

Abstract

BACKGROUND:

Inflammatory pseudotumor is a nonneoplastic process of unknown etiology most frequently involving the lungs and orbits. Primary intracranial inflammatory pseudotumors are exceptionally rare. The authors report a rare case of clinoidal inflammatory pseudotumor mimicking a medial sphenoid wing meningioma.

CASE DESCRIPTION:

A 24-year-old woman presented with visual diminution and proptosis in the left eye for one and a half years. Imaging revealed a medial sphenoid wing mass, which was surgically decompressed. Histopathology confirmed the diagnosis of inflammatory pseudotumor after which she was treated with steroids. The patient is doing well at 3 months' follow-up with resolution of proptosis and no further diminution of vision.

CONCLUSION:

Inflammatory pseudotumors can mimic a malignant tumor both radiologically and clinically. The treatment options consist of surgery, high-dose steroids, irradiation, and chemotherapeutic agents with variable therapeutic response. Intracranial involvement due to inflammatory pseudotumor is exceptionally rare. The importance of recognizing and appropriately diagnosing this rare intracranial pathology lies in prognostication and avoidance of overzealous treatment.

• Authors: Manish K Kasliwal, Ashish Suri, Deepak K Gupta, Vaishali Suri, Arvind Rishi, Bhawani S Sharma
• Journal: Surgical neurology (Surg Neurol) Vol. 70 Issue 5 Pg. 509-13; discussion 513 (Nov 2008) ISSN: 0090-3019 [Print] United States
• PMID: 18207558 (Publication Type: Case Reports, Journal Article, Review)

Topics

• Adult
• Cranial Fossa, Posterior
• Diagnosis, Differential
• Female
• Granuloma, Plasma Cell (diagnosis, drug therapy, surgery)
• Humans
• Meningioma (diagnosis)
• Skull Base Neoplasms (diagnosis)
• Sphenoid Bone