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Plasma cell granuloma: maxillary sinuses
M Muzaffar1, S I Hussain, A Chughtai
1Department of Pathology, Pakistan Naval Hospital SHIFA, Karachi.
Abstract:
Inflammatory pseudotumours or plasma cell granulomas are space-occupying, rounded masses appearing in various locations usually as an aftermath of recurrent infections. Recurrent pain and mass have been the most common presentations (Durst et al., 1977). These have been confused with tumours but radical surgical treatment is unnecessary, in the absence of life-threatening complications. The prognosis is excellent after excision. The nature and pathogenesis of the inflammatory pseudotumours, their presentation as fever and anaemia in some cases, are unknown. This report is probably the first case of a plasma cell granuloma involving the maxillary sinus causing focal erosion of the orbital wall, simulating a malignant tumour clinically.
Insights
Inflammatory pseudotumours, also known as plasma cell granulomas, are benign masses often linked to infections. This case highlights a rare instance of one in the maxillary sinus eroding the orbital wall, mimicking cancer.
Area of Science:
- Pathology
- Oncology
- Otorhinolaryngology
Background:
- Inflammatory pseudotumours (plasma cell granulomas) are benign, space-occupying masses often associated with recurrent infections.
- Common presentations include recurrent pain and palpable masses, though their exact nature and pathogenesis remain unclear.
- These lesions are frequently misdiagnosed as malignant tumors, leading to unnecessary aggressive treatments.
Observation:
- This report details a rare case of a plasma cell granuloma originating in the maxillary sinus.
- The lesion presented as a focal erosion of the orbital wall.
- Clinically, the presentation mimicked that of a malignant tumor.
Findings:
- The maxillary sinus plasma cell granuloma caused significant local destruction, specifically eroding the orbital wall.
- Despite the aggressive appearance, the lesion was confirmed as a benign inflammatory pseudotumour.
- This case underscores the potential for inflammatory lesions to present with destructive features.
Implications:
- Radical surgical intervention is often unnecessary for inflammatory pseudotumours, with excellent prognosis following complete excision.
- Accurate diagnosis is crucial to avoid overtreatment of these benign conditions.
- This case expands the known clinical spectrum of plasma cell granulomas, particularly their potential to involve the sinonasal region and mimic malignancy.