Tumefactive fibro-inflammatory lesions of the head and neck

Seven patients had tumefactive inflammatory fibrous lesions of the head similar in histologic appearance to Riedel's thyroiditis, sclerosing mediastinitis, and retroperitoneal fibrosis. Five patients were females, and the mean age at presentation was 48 years. Four patients presented clinically with a mass. Histologically, these lesions were characterized by an admixture of mature fibrous tissue and an inflammatory infiltrate of lymphocytes and scattered polymorphonuclear leukocytes. Initially, all patients had been treated surgically. Two patients received radiation therapy when recurrent disease could not be controlled surgically. Five of the six patients on whom follow-up information was available were alive at follow-up that ranged from 14 to 49 months (mean 29). These lesions are distinct histologically from desmoid tumors, fibromatoses, and nodular fasciitis. The spectrum of fibrosclerosing lesions (Riedel's thyroiditis, idiopathic mediastinal fibrosis, retroperitoneal fibrosis, and sclerosing cholangitis) probably includes this group of tumefactive inflammatory fibrous lesions of the head.