Sin Eui Gyu, Lee Junguee
Department of Neurosurgery, Konyang University Hospital, Daejeon, South Korea.
Department of Pathology, Konyang University Hospital, Daejeon, South Korea.
Case Rep Oncol. 2024 Jul 4;17(1):705-711. doi: 10.1159/000539718. eCollection 2024 Jan-Dec.
Inflammatory pseudotumor encompasses a broad range of non-neoplastic and neoplastic entities, including inflammatory myofibroblastic tumors (IMTs). Because it is a rare mesenchymal tumor of unknown etiology and pathogenesis, and its clinical symptoms and radiologic features are not distinctive, intracranial IMT could be misdiagnosed as other extra-axial tumors. Here, we present a case of intracranial IMT suspected to be a brain abscess.
In this case, a 73-year-old woman presented headaches, nausea, and vertigo. Brain computed tomography (CT) and magnetic resonance imaging showed 4 × 3 cm sized oval rim-enhanced lesion on the left cerebellopontine angle. Considering the patient's history of otitis media and CT findings, we hypothesized that this lesion was a chronic brain abscess. The initial burr hole drain surgery was unsuccessful because there was no abscess, leading to a second radical excision surgery. Histopathological and immunohistochemical analyses eventually revealed a final diagnosis of intracranial IMT.
Intracranial IMT is a rare disease with unknown pathogenesis. Diagnosis primarily depends on histopathological and immunohistochemistry analyses. As observed in our case, this disease may be mistaken for meningiomas, solitary fibrous tumors, or chronic abscesses due to its rare occurrence.
炎性假瘤涵盖了广泛的非肿瘤性和肿瘤性实体，包括炎性肌纤维母细胞瘤（IMT）。由于它是一种病因和发病机制不明的罕见间叶性肿瘤，且其临床症状和影像学特征不具特异性，颅内IMT可能会被误诊为其他轴外肿瘤。在此，我们报告一例疑似脑脓肿的颅内IMT病例。
该病例为一名73岁女性，出现头痛、恶心和眩晕症状。脑部计算机断层扫描（CT）和磁共振成像显示在左侧桥小脑角有一个大小为4×3厘米的椭圆形边缘强化病灶。考虑到患者的中耳炎病史和CT表现，我们推测该病灶为慢性脑脓肿。最初的钻孔引流手术未成功，因为没有发现脓肿，随后进行了二次根治性切除手术。组织病理学和免疫组织化学分析最终确诊为颅内IMT。
颅内IMT是一种发病机制不明的罕见疾病。诊断主要依赖于组织病理学和免疫组织化学分析。如我们的病例所示，由于其罕见性，这种疾病可能会被误诊为脑膜瘤、孤立性纤维瘤或慢性脓肿。
