Multiple Inflammatory Pseudotumors—A Case Report and Literature Review—

  • Nakamura Homare
    Department of Neurosurgery, St. Marianna University School of Medicine Yokohama City Seibu Hospital
  • Kawaguchi Kimiyuki
    Department of Neurosurgery, St. Marianna University School of Medicine Yokohama City Seibu Hospital
  • Onodera Hidetaka
    Department of Neurosurgery, St. Marianna University School of Medicine Yokohama City Seibu Hospital
  • Sakakibara Yohtaro
    Department of Neurosurgery, St. Marianna University School of Medicine Yokohama City Seibu Hospital
  • Yanagisawa Nobuyuki
    Department of Diagnostic Pathology, St. Marianna University School of Medicine Yokohama City Seibu Hospital

Bibliographic Information

Other Title
  • Multiple inflammatory pseudotumorの1例

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Description

<p>  A 63-year-old woman presented with a rare case of both intraspinal and orbital inflammatory pseudotumors (IPT). The former IPT manifested as progressive dysesthesia and pain in her left leg. MRI revealed a mass at L5/S1 with extradural and intradural components, showing low signal on T1 and T2-weighted images and strong homogeneous enhancement on gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA). Intraoperatively, an extradural granulomatous lesion that was slightly adhesive to the dura mater was found and removed. Histological examination of the resected lesions revealed the presence of excessive collagen fibers infiltrated with polyclonal lymphocytes, plasma cells macrophages, and giant cells. Only a small number of IgG4-positive cells were observed. Immunostaining for the epithelial membrane antigen was negative. No malignant cells were detected. The diagnosis was consistent with IPT. Two months after surgery, orbital IPT developed. She was treated with steroids. After one year, no aggravation was observed.</p><p>  IPTs usually occur in the lung and the orbit, but rarely in the spine. Although spinal IPTs are typically solitary lesions, we present a case of a patient with multiple IPTs and review the literature.</p>

Journal

  • Spinal Surgery

    Spinal Surgery 34 (3), 302-306, 2020

    The Japanese Society of Spinal Surgery

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