Inflammatory pseudotumour of nasal cavity and sinuses: a case report with review of literature

Abstract

Inflammatory pseudotumor (IPT) is a benign non-neoplastic rare mass lesion clinically and radiologically simulating neoplasm thus generally requiring a biopsy to exclude malignancy. It occurs almost anywhere all over the body with most common locations being lungs and orbit with only 15% of it occurs in head and neck non-orbital region. Here we are describing a case of 52-year-old female patient having bleeding from left nostril with swelling, redness of left side of nose and face, initially painless. Radiological imaging was highly suspicious of malignancy. HPE showed inflammatory lesions. The fungal culture report of nasal specimen was showing ‘no growth’. Blood examination was within normal limits; blood sugar levels was within normal limits. Systemic steroids were started which showed drastic improvements. Most of the IPTs in head and neck region shows a benign course, but cases related to paranasal sinuses seems to be of highly aggressive behaviour, with poor response to surgery, chemotherapy, radiotherapy; showing recurrences and fatal outcome. In such cases corticosteroid therapy generally shows good outcome. Tumors for which complete resection would result in morbidity may be treated with corticosteroids conservatively and close follow up. Understanding of natural history and pathophysiologic features of IPTs is helpful in differential diagnosis and may prevent unnecessary surgeries.