Kansara Sagar, Bell Diana, Johnson Jason, Zafereo Mark
Department of Head and Neck Surgery, MD Anderson Cancer Center, The University of Texas Medical School at Houston, USA.
Department of Pathology, MD Anderson Cancer Center, USA.
Neuroradiol J. 2016 Dec;29(6):440-446. doi: 10.1177/1971400916665377. Epub 2016 Sep 20.
Inflammatory pseudotumor (IP) is an uncommon idiopathic lesion that often imitates malignancy clinically and radiologically. Inflammatory pseudotumors have been found to occur in various sites but rarely in the head and neck. The histopathology, imaging, and treatment of three unique cases of head and neck inflammatory pseudotumors are described in this case series. Patients in Cases 1 and 2 presented with right level II neck mass and left parotid tail mass, respectively. The patient in Case 3 presented with otalgia, jaw pain and trismus, and a left parapharyngeal space mass. The tumors in Cases 1 and 3 significantly decreased in size with tapered courses of oral corticosteroids. The tumor in Case 2 was surgically excised without disease recurrence. Malignancy must be ruled out with incisional or excisional biopsy. Treatment includes surgical excision, oral corticosteroids, or both. The literature shows that radiotherapy and small-molecule inhibitors may be promising alternatives.
炎性假瘤（IP）是一种罕见的特发性病变，在临床和放射学上常类似恶性肿瘤。已发现炎性假瘤可发生于多个部位，但在头颈部很少见。本病例系列描述了3例独特的头颈部炎性假瘤的组织病理学、影像学及治疗情况。病例1和病例2的患者分别表现为右侧Ⅱ区颈部肿块和左侧腮腺尾部肿块。病例3的患者表现为耳痛、颌部疼痛和牙关紧闭，以及左侧咽旁间隙肿块。病例1和病例3的肿瘤在口服糖皮质激素逐渐减量的疗程中体积显著减小。病例2的肿瘤经手术切除，无疾病复发。必须通过切开活检或切除活检排除恶性肿瘤。治疗方法包括手术切除、口服糖皮质激素或两者兼用。文献表明，放疗和小分子抑制剂可能是有前景的替代治疗方法。
