Granulomatosis With Polyangiitis Presenting as an Infratemporal Fossa Mass
Sulgi Kim1, Steven M Johnson2, Erin Lopez1
1Department of Otolaryngology/Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Clinical Medicine Insights. Case Reports
|March 30, 2023
Summary
Granulomatosis with polyangiitis (GPA) can manifest as an infratemporal mass. Early diagnosis via biopsy and imaging is crucial for timely treatment and preventing organ damage.
Area of Science:
- Vascular Inflammation
- Autoimmune Disorders
- Head and Neck Pathology
Background:
- Granulomatosis with polyangiitis (GPA) is a rare systemic vasculitis affecting small to medium-sized vessels.
- GPA commonly involves the respiratory tract and kidneys, but can affect other organs.
- Atypical presentations of GPA can pose diagnostic challenges.
Observation:
- A 51-year-old male presented with chronic right cheek and facial pain.
- MRI revealed an infratemporal mass with extension towards the orbit, raising suspicion for malignancy.
- Endoscopic biopsy showed arterial luminal obliteration with non-necrotizing granulomas.
Findings:
- Histopathological examination confirmed granulomatosis with polyangiitis as the cause of the infratemporal mass.
- The observed arterial changes included significant luminal narrowing due to granulomatous inflammation.
- The patient's symptoms improved with steroid and immunosuppressive therapy.
Implications:
- This case highlights the importance of considering GPA in the differential diagnosis of infratemporal masses.
- Prompt diagnosis and treatment of GPA can prevent irreversible organ damage.
- Multidisciplinary evaluation including imaging and biopsy is essential for managing complex GPA cases.
