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Open Access 01-12-2016 | Case report

Intracranial extension of orbital inflammatory pseudotumor: a case report and literature review

Authors: Enrico Tedeschi, Lorenzo Ugga, Ferdinando Caranci, Francesca Califano, Sirio Cocozza, Giacomo Lus, Arturo Brunetti

Published in: BMC Neurology | Issue 1/2016

Abstract

Background

Orbital inflammatory pseudotumor is a rare inflammatory condition of unknown cause that may extend intracranially, usually as a dural-based infiltrate. Here we report the first case of orbital pseudotumor presenting with intra-axial Magnetic Resonance Imaging (MRI) changes.

Case presentation

A 57-year-old white female, with a 3-month history of headache and right palpebral edema, presented with marked right temporal lobe edema with ominous MRI appearance, and ipsilateral alterations of orbital and periorbital structures. Following steroid therapy, both intracranial and orbital involvement dramatically improved.

Conclusion

Orbital inflammatory pseudotumor with chronic inflammation may infrequently present with intracranial involvement, mimicking more aggressive diseases, even showing intra-axial enhancement after i.v. contrast administration in brain MRI. Awareness of this possibility may help neurologists to choose the appropriate therapeutic approach.

Coffin CM, Watterson J, Priest JR, Dehner LP. Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor): a clinicopathologic and immuno-histochemical study of 84 cases. Am J Surg Pathol. 1995;19:859–72.CrossRefPubMed

Narla LD, Newman B, Spottswood SS, Narla S, Kolli R. Inflammatory pseudotumor. RadioGraphics. 2003;23:719–29.CrossRefPubMed

Patnana M, Sevrukov AB, Elsayes KM, Viswanathan C, Lubner M, Menias CO. Inflammatory pseudotumor: the great mimicker. Am J Roentgenol. 2012;198:217–27.CrossRef

Som PM, Curtin HD. Head and neck imaging. 5th ed. St Louis: Mosby; 2011. p. 682–5.

Park SB, Lee JH, Weon YC. Imaging findings of head and neck inflammatory pseudotumor. Am J Roentgenol. 2009;193:1180–6.CrossRef

Ding ZX, Lip G, Chong V. Idiopatic orbital pseudotumour. Clin Radiol. 2011;66:886–92.CrossRefPubMed

Ginat DT, Bokhari A, Bhatt S, Dogra V. Inflammatory pseudotumors of the head and neck in pathology-proven cases. J Neuroradiol. 2012;39:110–5.CrossRefPubMed

Fortson JK, Shapshay SM, Weiter JJ, Vaughan CW, Strong MS. Otolaryngologic manifestations of orbital pseudotumors. Otolaryngol Head Neck Surg. 1980;88:342–8.PubMed

Eshaghian J, Anderson RL. Sinus involvement in inflammatory orbital pseudotumor. Arch Ophthalmol. 1981;99:627–30.CrossRefPubMed

10.

Pillai P, Saini JS. Bilateral sino-orbital pseudotumour. Can J Ophthalmol. 1988;23:177–80.PubMed

11.

Cruz AA, Akaishi PM, Chahud F, Elias JJ. Sclerosing inflammation in the orbit and in the pterygopalatine and infratemporal fossae. Ophthal Plast Reconstr Surg. 2003;19:201–6.CrossRefPubMed

12.

Weber AL, Romo LV, Sabates NR. Pseudotumor of the orbit. Clinical, pathologic, and radiologic evaluation. Radiol Clin North Am. 1999;37:151–68.CrossRefPubMed

13.

Muccio CF, Di Blasi A, Esposito G, Brunese L, D’Arco F, Caranci F. Perfusion and spectroscopy magnetic resonance imaging in a case of lymphocytic vasculitis mimicking brain tumor. Pol J Radiol. 2013;78:66–9.CrossRefPubMedPubMedCentral

14.

Lee EJ, Jung SL, Kim BS, Ahn KJ, Kim YJ, Jung AK, et al. MR Imaging of orbital inflammatory pseudotumors with extraorbital extension. Korean J Radiol. 2005;6:82–8.CrossRefPubMedPubMedCentral

15.

Mahr MA, Salomao DR, Garrity JA. Inflammatory orbital pseudotumor with extension beyond the orbit. Am J Ophthalmol. 2004;138:396–400.CrossRefPubMed

16.

Ayala AS, Fernández Sarabia T, Cabeza Martinez B, Moya MJ, Menéndez FL, García PZ. Orbital pseudotumor with intra-cranial extension. Eur Radiol. 2000;10:1505.CrossRefPubMed

17.

Clifton AG, Borgstein RL, Moseley IF, Kendall BE, Shaw PJ. Intracranial extension of orbital pseudotumour. Clin Radiol. 1992;45:23–6.CrossRefPubMed

18.

De Jesús O, Inserni JA, Gonzalez A, Colón LE. Idiopathic orbital inflammation with intracranial extension. Case report. J Neurosurg. 1996;85:510–3.CrossRefPubMed

19.

Bencherif B, Zouaoui A, Chedid G, Kujas M, Van Effenterre R, Marsault C. Intracranial extension of an idiopathic orbital inflammatory pseudotumor. AJNR Am J Neuroradiol. 1993;14:181–4.PubMed

20.

Frohman LP, Kupersmith MJ, Lang J, Reede D, Bergeron RT, Aleksic S, et al. Intracranial extension and bone destruction in orbital pseudotumor. Arch Ophthalmol. 1986;104:380–4.CrossRefPubMed

21.

Noble SC, Chandler WF, Lloyd RV. Intracranial extension of orbital pseudotumor: a case report. Neurosurgery. 1986;18:798–801.CrossRefPubMed

22.

Kaye AH, Hahn JF, Craciun A, Hanson M, Berlin AJ, Tubbs RR. Intracranial extension of inflammatory pseudotumor of the orbit. Case report. J Neurosurg. 1984;60:625–9.CrossRefPubMed

23.

Olmos PR, Falko JM, Rea GL, Boesel CP, Chakeres DW, McGhee DB. Fibrosing pseudotumor of the sellar and parasellar area producing hypopituitarism and multiple cranial nerve palsies. Neurosurgery. 1993;32:1015–21.CrossRefPubMed

24.

Soares D, Crandon I, Char G, Webster D, Carpenter R. Orbital pseudotumour with intracranial extension. A case report. West Indian Med J. 1998;47:68–71.PubMed

25.

Zborowska B, Ghabrial R, Selva D, McCluskey P. Idiopathic orbital inflammation with extraorbital extension: case series and review. Eye. 2006;20:107–13.CrossRefPubMed

26.

Saifudheen K, Jose J, Gafoor VA. Inflammatory pseudotumor of the head presenting with hemiparesis and aphasia. Case Rep Neurol Med. 2011;2011:176546.PubMedPubMedCentral

27.

Leach JL, Fortuna RB, Jones BV, Gaskill-Shipley MF. Imaging of cerebral venous thrombosis: current techniques, spectrum of findings, and diagnostic pitfalls. Radiographics. 2006;S19–41.

28.

Yuh WT, Simonson TM, Wang AM, Koci TM, Tali ET, Fisher DJ, et al. Venous sinus occlusive disease: MR findings. AJNR Am J Neuroradiol. 1994;15(2):309–16.PubMed

Title: Intracranial extension of orbital inflammatory pseudotumor: a case report and literature review
Authors: Enrico Tedeschi
Lorenzo Ugga
Ferdinando Caranci
Francesca Califano
Sirio Cocozza
Giacomo Lus
Arturo Brunetti
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Neurology / Issue 1/2016
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-016-0550-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intracranial extension of orbital inflammatory pseudotumor: a case report and literature review

Abstract

Background

Case presentation

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusion

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