Tumefactive fibroinflammatory lesion: a rare aetiology for a neck mass in an old Iranian man

Binesh, Fariba; Taghipour, Shokouh; Navabii, Hossein

doi:10.1136/bcr.12.2010.3572

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Further histological characteristics which seem to be consistent throughout described cases are that of a reactive appearance, 4 varying amounts of lymphocytic inflammation in a perivascular formation, 6 and trapping of nerves and vessels in poorly cellular, ubiquitous fibrosis 2,7–9 …”

Section: Discussionsupporting

confidence: 65%

Tumefactive fibroinflammatory lesion: Case report of a rare entity causing progressive destruction of the facial skeleton

2021

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This report documents the dramatic destruction of the patient's facial skeleton, particularly the mandible, and the challenges associated with making a diagnosis. It aims to raise the awareness of clinicians regarding the clinical presentation of tumefactive fibroinflammatory lesions, and to facilitate diagnosis and treatment planning of similar cases in the future. I N TRODUC TIONA tumefactive fibroinflammatory lesion (TFIL) is a rare idiopathic tumour, usually occurring in the head and neck region. Though it is benign, clinically and radiographically it appears malignant because of its aggressive clinical course. 1 TFILs are locally invasive and may cause pronounced bony destruction, but do not metastasize. [2][3][4] It is suspected to be part of a wider spectrum of entities called inflammatory pseudotumours. 3 The aetiology is unknown and little evidence base exists regarding the most appropriate management of TFILs. This report documents the case of a now 72-year-old male and the challenges involved in reaching this diagnosis. CASE R EPORTA 63-year-old male was referred by his General Medical Practitioner in 2011 to the Oral and Maxillofacial Surgery department. He complained of intermittent left facial swelling with discomfort and restricted mouth opening.Medically the patient had Korsakoff's syndrome, diverticulosis, angina and cardiac arrhythmia. He had been admitted to hospital multiple times following episodes of collapse. Previous interventions included insertion of a pacemaker and excision of an undifferentiated sarcoma from the left groin. He was a heavy pipe smoker of 48 years and had a history of excessive alcohol consumption. He previously had input from homelessness services and is now aided by

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Section: Discussionsupporting

confidence: 65%

Tumefactive fibroinflammatory lesion: Case report of a rare entity causing progressive destruction of the facial skeleton

2021

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“…first described the abnormality in 1975 and named this as sclerosing cervicitis [3]. Histologically identical lesions were subsequently reported involving parotid gland, nasal and paranasal sinuses, maxillary antrum, infratemporal fossa, lung, and extremities [4-7]. This lesion clinically simulates a malignant neoplasm without metastasis, but is histologically benign.…”

Section: Introductionmentioning

confidence: 99%

“…This lesion clinically simulates a malignant neoplasm without metastasis, but is histologically benign. Its histopathologic appearance is nearly identical to that of fibrosclerotic lesions of the mediastinum and retroperitoneum, as well as of Riedel’s thyroiditis [ 4 ]. The etiology of TFIL is unknown.…”

Section: Introductionmentioning

confidence: 99%

Tumefactive fibroinflammatory lesion presenting with head and neck fibrosclerosing lesions and orbital pseudotumors: a case report

et al. 2013

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IntroductionTumefactive fibroinflammatory lesion is an idiopathic fibrosclerosing disorder occurring in the head and neck region. It is one of a broad spectrum of entities named inflammatory pseudotumors and, as the name suggests, it mimics a lot of diseases such as malignancies or infections. Combined with its rarity, tumefactive fibroinflammatory lesion can be a tremendous diagnostic challenge. This case report describes a case of tumefactive fibroinflammatory lesion, which was initially thought to be peri-orbital and mandibular osteomyelitis caused by Aspergillus. A lengthy work up ensued and was required to reach the final diagnosis.Case presentationA 64-year-old Asian man with a history of diabetes mellitus and chronic kidney disease who was on hemodialysis presented with worsening exophthalmos and relapsing trismus. He was diagnosed as “mandibular osteomyelitis” about 20 years ago. Since then he had suffered chronic relapsing exophthalmos and jaw pain with numerous medical treatments. In 2011 he was diagnosed as peri-orbital and intramandibular aspergillosis because a serum Aspergillus galactomannan assay was positive. He was treated with multiple antifungal medications to no avail. A biopsy of his orbital lesions was not revealing. After repeated biopsies, we finally concluded that the patient was suffering from tumefactive fibroinflammatory lesion. Corticosteroid therapy was initiated with prompt response.ConclusionsTumefactive fibroinflammatory lesion is a rare inflammatory benign tumor, which mimics many inflammatory and neoplastic disorders. Conventional work up including biopsy may not lead to the diagnosis without understanding this entity. Awareness of this disorder will aid early diagnosis and treatment.

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“…Diseases with a similar clinical phenotype that requires differentiation include IgG4-RD ( 6), Riedel's thyroiditis (12), fibrosarcoma (27), IMT, sclerosing cholangitis, lacrimal gland fibrosis, parotid fibrosis, and mediastinal and retroperitoneal tumors (10). To distinguish these diseases, a histopathological examination is required (6,22).…”

Section: Discussionmentioning

confidence: 99%

A Tumefactive Fibroinflammatory Lesion of the Head and Neck Mimicking Immunoglobulin G4-related Disease

et al. 2023

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A 67-year-old woman with a 5-year history of recurrent swollen eyelids and epistaxis, diagnosed as immunoglobulin G4-related diseases (IgG4-RD) based on hyper-IgG4-emia and IgG4-positive cell infiltration to the lesion, was referred to our department due to recurrent symptoms despite corticosteroid therapies. Computed tomography revealed an osteoclastic sinus mass with prominent neutrophil infiltration and necrosis that was incompatible with IgG4-RD histopathologically. Finally, she was diagnosed with a tumefactive fibroinflammatory lesion (TFIL) of the head and neck and treated with high-dose corticosteroids. Physicians should remember that TFIL can mimic IgG4-RD in the head and neck region with prominent neutrophil infiltration and necrosis.

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Tumefactive fibroinflammatory lesion: a rare aetiology for a neck mass in an old Iranian man

Cited by 5 publications

References 14 publications

Tumefactive fibroinflammatory lesion: Case report of a rare entity causing progressive destruction of the facial skeleton

Tumefactive fibroinflammatory lesion: Case report of a rare entity causing progressive destruction of the facial skeleton

Tumefactive fibroinflammatory lesion presenting with head and neck fibrosclerosing lesions and orbital pseudotumors: a case report

A Tumefactive Fibroinflammatory Lesion of the Head and Neck Mimicking Immunoglobulin G4-related Disease

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