Inflammatory pseudotumor: A 20-year single institutional experience

Document Type : Original Article

Authors

1 Department of Pathology, University College Hospital; Department of Pathology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria

2 Department of Pathology, University College Hospital, Ibadan, Oyo State, Nigeria, Nigeria

Abstract

Background: Inflammatory pseudotumor (IPT) is a relatively rare benign disease. The aim of the study was to demonstrate the demographic distribution, clinical presentation, and histomorphological characteristics of IPT while highlighting its associated diagnostic challenges. Materials and Methods: A retrospective cross-sectional review of all the IPT diagnosed in our institution between January 1999 and December 2018 was conducted. The samples were received from within and outside the hospital facility. The demographic data, clinical history, and histologic reports were reviewed. Results: A total of 25 cases of histologically confirmed IPT were seen. Patients' age ranges from 7 to 74 years with a mean age of 38.96 years and standard deviation ± 17.94 years. There was a bimodal peak occurrence in the third and fifth decades. Most of the patients were adults (23, 92%), whereas only 2 (8%) were children. There was a female preponderance with a male-to-female ratio of 1:2.6. The head and neck had the highest number of cases (44%), followed by the gastrointestinal tract (GIT) (40%). Eight (73%) of head and neck cases occurred in the orbit. The presenting complaints depended on the site of the lesion with pain and swelling being the commonest symptoms irrespective of the site of the lesions. Two cases of bilateral IPT were observed. Immunohistochemistry was used in a certain condition of diagnostic dilemma. Conclusion: This study showed a female preponderance of IPT with the head and neck and GIT being the most common location. It is important to rule out other differentials in the diagnosis of IPT.

Keywords

1.
Garg PK. Inflammatory pseudotumor of urinary bladder: Beware lest we forget. Urol Ann 2014;6:390-1.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
DiFiore JW, Goldblum JR. Inflammatory myofibroblastic tumour of the small intestine. J Am Coll Surg 2002;194:502-6.  Back to cited text no. 2
    
3.
Chan JK. Inflammatory pseudotumour: A family of lesions of diverse nature and etiologies. Adv Anat Pathilogy 1996;3:157-71.  Back to cited text no. 3
    
4.
Narla LD, Newman B, Spottswood SS, Narla S, Kolli R. Inflammatory pseudotumor. Radiographics 2003;23:719-29.  Back to cited text no. 4
    
5.
Alireza M, Khaleghnejad TA, Naser S, Siamak ST, Marina P, Leila M, et al. Abdominal inflammatory myofibroblastic tumor : Report on four cases and review of literature case presentation. Iran J Pediatr 2011;21:543-8.  Back to cited text no. 5
    
6.
Dehner LP. The enigmatic inflammatory pseudotumours: The current state of our understanding, or misunderstanding. J Pathol 2000;192:277-9.  Back to cited text no. 6
    
7.
Asadi-Amoli F, Azadbakht F, Jahanzad E, Sadeghie-Tari A, Akbarzadeh-Jahromi M. Inflammatory pseudotumor of the orbit: A histopathologic and immunohistochemical study of 32 cases. Iran J Pathol 2008;3:218-24.  Back to cited text no. 7
    
8.
World Health Organization Classification of Tumours Pathology and Genetics of Tumours of Soft Tissue and Bone. In: Fletcher CD, Unni K, Mertens F, editors. Inflammatory Myofibroblastic Tumour. 4th ed.. Lyon: IARC Press; 2002.  Back to cited text no. 8
    
9.
Groenveld RL, Raber MH, Oosterhof-Berktas R, Eijken E, Klaase JM. Abdominal inflammatory myofibroblastic tumor. Case Rep Gastroenterol 2014;8:67-71.  Back to cited text no. 9
    
10.
Butrynski JE, D'Adamo DR, Hornick JL, Dal Cin P, Antonescu CR, Jhanwar SC, et al. Crizotinib in ALK-rearranged inflammatory myofibroblastic tumor. N Engl J Med 2010;363:1727-33.  Back to cited text no. 10
    
11.
Demirhan O, Ozkara S, Yaman M, Kaynak K. A rare benign tumor of the lung: Inflammatory myofibroblastic tumor – Case report. Respir Med Case Rep 2013;8:32-5.  Back to cited text no. 11
    
12.
Kim JH, Cho JH, Park MS, Chung JH, Lee JG, Kim YS, et al. Pulmonary inflammatory pseudotumor – A report of 28 cases. Korean J Intern Med 2002;17:252-8.  Back to cited text no. 12
    
13.
Nwafor C, Ekanem VJ. A study of the histopathologic pattern of orbito-ocular disease in a tertiary hospital in Nigeria. Sahel Med J 2014;17:60-4.  Back to cited text no. 13
    
14.
Jeon YK, Chang KH, Suh YL, Jung HW, Park SH. Inflammatory myofibroblastic tumor of the central nervous system: Clinicopathologic analysis of 10 cases. J Neuropathol Exp Neurol 2005;64:254-9.  Back to cited text no. 14
    
15.
Bjelovic M, Micev M, Spica B, Babic T, Gunjic D, Djuric A, et al. Primary inflammatory myofibroblastic tumor of the stomach in an adult woman: A case report and review of the literature. World J Surg Oncol 2013;11:35.  Back to cited text no. 15
    
16.
Chaudhary T, Singh SK, Harsh M. Jejunal inflammatory myofibroblastic tumor : A rare entity. Int Surg J 2017;4:2095-7.  Back to cited text no. 16
    
17.
Leon CJ, Castillo J, Mebold J, Cortez L, Felmer R. Inflammatory myofibroblastic tumor of the stomach: An unusual complication after gastrectomy. Gastrointest Endosc 2006;63:347-9.  Back to cited text no. 17
    
18.
Morar R, Bhayat A, Hammond G, Bruinette H, Feldman C. Inflammatory pseudotumour of the lung: a case report and literature review. Case Rep Radiol. 2012;2012:214528. doi:10.1155/2012/214528  Back to cited text no. 18
    
19.
Sedlic T, Scali EP, Lee WK, Verma S, Chang SD. Inflammatory pseudotumours in the abdomen and pelvis: A pictorial essay. Can Assoc Radiol J 2014;65:52-9.  Back to cited text no. 19
    
20.
Huang Y, Li LP, Wang J, Lun ZJ, Li W, Yang Z. Inflammatory pseudotumor of the colon causing intussusception: A case report and literature review. World J Gastroenterol 2015;21:704-10.  Back to cited text no. 20
    
21.
Yuen SJ, Rubin PA. Idiopathic orbital inflammation: Distribution, clinical features, and treatment outcome. Arch Ophthalmol 2003;121:491-9.  Back to cited text no. 21
    
22.
Shehibo A, Admassu F, Bekele T, Solomon M, Solomon L, Gordon DM. Bilateral orbital pseudotumor in a 3-year-old child: A case report. J Trop Pediatr 2018;64:241-4.  Back to cited text no. 22