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Primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus
Richard J Vivero1, Pooja H Doshi, Jean Anderson Eloy
1Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA. rvivero@med.miami.edu
Abstract:
Inflammatory pseudotumor is a well known but poorly understood pathologic entity. It is associated with an unusual growth of fibrotic tissue admixed with varying amounts of inflammation that displaces and compresses normal anatomic structures, resulting in dysfunction. Pseudotumors have been found in multiple locations-the orbit in particular-but to the best of our knowledge, none has previously been reported as an isolated sinus lesion. We describe a case of primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus that manifested as recurrent unilateral maxillary sinusitis in a 47-year-old woman. The patient was managed with surgery and oral steroids with full resolution of her symptoms. We also review the presentation, diagnosis, and treatment of fibroinflammatory pseudotumors within the context of the current literature.
Insights
Inflammatory pseudotumor, a rare sinus lesion, can mimic recurrent sinusitis. Surgical and steroid treatment resolved symptoms in a case of primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus.
Area of Science:
- Pathology
- Otolaryngology
- Surgical Oncology
Background:
- Inflammatory pseudotumor (IPT) is a poorly understood condition characterized by fibrotic tissue and inflammation.
- IPTs can occur in various locations, with orbital involvement being most common.
- Isolated sinus IPTs are exceptionally rare.
Observation:
- A 47-year-old woman presented with recurrent unilateral maxillary sinusitis.
- Imaging and clinical presentation suggested an isolated sinus lesion.
- The lesion was diagnosed as a primary sclerosing fibroinflammatory pseudotumor of the maxillary sinus.
Findings:
- The patient underwent surgical management and received oral steroids.
- Complete resolution of sinusitis symptoms was achieved post-treatment.
- This case represents the first reported instance of an isolated maxillary sinus IPT.
Implications:
- This case expands the known spectrum of IPT presentations.
- Highlights the importance of considering rare fibroinflammatory lesions in chronic sinusitis diagnosis.
- Suggests a potential therapeutic approach involving surgery and corticosteroids for similar cases.
