IgG4 Related Sclerosing Inflammatory Pseudotumor Simulating Cholesteatoma Of The Temporal Bone
Article Sidebar
Main Article Content
Abstract
Introduction
Sclerosing inflammatory pseudotumor of the temporal bone is a rare fibro-inflammatory, benign albeit locally aggressive pathological entity.
Case Report
We report a case of Sclerosing inflammatory pseudotumor of the temporal bone, simulating a cholesteatoma. A 61-year-old female presented with right otalgia, hearing loss, facial pain and imbalance. Ear microscopy revealed a pulsatile mass in the external auditory canal. HRCT temporal bone and MRI reported soft tissue mass in the right middle ear and mastoid air cells, causing attenuation of the ossicles with erosion through the tegmen and mastoid cortex. The patient underwent canal wall down tympanomastoidectomy. The histopathology with immunohistochemistry was consistent with IgG4 related sclerosing inflammatory pseudotumor.
Discussion
This case report explores the similarities as well as the clinical differences between cholesteatoma and IgG4 sclerosing inflammatory pseudotumor of temporal bone, along with the diagnostic and treatment challenges. It is often mistaken for neoplasm or cholesteatoma, hence should be considered as a differential diagnosis.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Gleason J. Idiopathic Myositis involving the extraocular muscles. Ophthalmology Rec 1903;12:471–8
Schiffenbauer AI, Wahl C, Pittaluga S. IgG4-related disease presenting as recurrent mastoiditis. Laryngoscope. 2012;122:681–684. DOI: 10.1002/lary.22486
Mulder JJ, Cremers WR, Joosten F. Fibroinflammatory pseudotumor of the ear. A locally destructive benign lesion. Arch Otolaryngol Head Neck Surg 1995;121(8):930-3
Ortlip, T. E., Drake, V. E., Raghavan, P., Papadimitriou, J. C., Porter, N. C., Eisenman, D. J., & Hertzano, R. (2017). Inflammatory Pseudotumor of the Temporal Bone. Otology & Neurotology, 38(7), 1024–1031. DOI:10.1097/mao.0000000000001465
Prabhu RS, Kandula S, Liebman L. Association of clinical response and long-term outcome among patients with biopsied orbital pseudotumor receiving modern radiation therapy. Int J Radiat Oncol Biol Phys 2013;85:643–9
Prabhu RS, Kandula S, Liebman L, Wojno TH, Hayek B, Hall WA, Shu HK, Crocker I. Association of clinical response and long-term outcome among patients with biopsied orbital pseudotumor receiving modern radiation therapy. Int J Radiat Oncol Biol Phys. 2013 Mar 1;85(3):643-9. doi: 10.1016/j.ijrobp.2012.06.033.