Case Report Rare presentation of CNS manifestation of pseudo inflammatory tumor which responded to steroid
Rare presentation of CNS manifestation of pseudo inflammatory tumor
DOI:
https://doi.org/10.15713/ins.bhj.185Keywords:
IgG4, 7th and 8th nerve involvement, benign lesion, MRI skull baseAbstract
Abstract:
Aim- Rare presentation of CNS manifestation of pseudo inflammatory tumor which responded to steroid.
Background- Inflammatory pseudotumor are rare, benign, tumor-like lesions characterized by chronic inflammatory cell infiltration, which can mimic malignant tumors both clinically and radiologically.
Case Description- Here, we present a case of a patient diagnosed with an inflammatory pseudotumor involving the left 7th and 8th cranial nerves, who presented with symptoms of severe headache, recurrent vomiting, dizziness, and gait ataxia. Initial examination revealed no fever or other systemic symptoms, and MRI imaging showed enhancement along the left 7th and 8th nerve complex.
Conclusion-Elevated serum IgG4 levels supported an inflammatory etiology, while cerebrospinal fluid (CSF) analysis and other tests ruled out infection or malignancy. The patient showed significant improvement in symptoms after corticosteroid therapy with IV dexamethasone and supportive care
Clinical Significance-This case highlights the diagnostic challenge posed by inflammatory pseudotumor in cranial nerves and underscores the importance of distinguishing them from other lesions to guide appropriate treatment.
References
References:
Seol JB, Loevner LA, O'Malley BW Jr., et al . Inflammatory pseudotumor of the trigeminal nerve: a neoplastic mimic you do not want to miss. AJNR Am J Neuroradiol 2009;30:1941–43
Nimsky C., Kolodziej M: Inflammatory pseudotumor: a rare intracranial lesion. World Neurosurg 2012; 77: pp. 89-90.
Saifudheen K., Jose J., Gafoor V.A: Inflammatory pseudotumor of the head presenting with hemiparesis and aphasia. Case Rep Neurol Med 2011; 2011: pp. 1-4.
Patnana M., Sevrukov A.B., Elsayes K.M., et. al.: Inflammatory pseudotumor: the great mimicker. AJR Am J Roentgenol 2012; 198: pp. W217-W227.
Ortlip T.E., Drake V.E., Raghavan P., et. al.: Inflammatory pseudotumor of the temporal bone: a case series. Otol Neurotol 2017; 38: pp. 1024-1031.
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