Published online Nov 6, 2023. doi: 10.12998/wjcc.v11.i31.7724
Peer-review started: September 12, 2023
First decision: September 19, 2023
Revised: September 27, 2023
Accepted: October 17, 2023
Article in press: October 17, 2023
Published online: November 6, 2023
This report describes a case of intracranial multiple inflammatory pseudotumors (IP) after endoscopic resection of a craniopharyngioma, which is relatively rarely reported in the literature, and neurosurgeons should be aware of its existence.
Herein, we report the case of a 56-year-old man who developed decreased visual acuity and blurred vision without obvious cause or inducement on April 27, 2020. To seek further treatment, he went to the Department of Neurosurgery, Clinical Medical College, Yangzhou University. After falling ill, there was no nausea, vomiting, limb convulsions, obvious disturbance of consciousness, speech disorders, cough, or persistent fever. The neurological examination findings were normal, and pituitary magnetic resonance imaging (MRI) revealed multiple nodules with abnormal signals in the sellar region. The diagnosis was craniopharyngioma. We performed total resection of the tumor via transnasal endoscopy, and the postoperative pathology suggested that the type of tumor was craniopharyngioma. Six months after the operation, the patient experienced sudden hearing loss in the right ear, tinnitus in both ears, and numbness on the right side of the face and head. Meanwhile, cranial MRI showed multiple IP. After steroid hormone and anti-inflammatory therapy, the above symptoms did not significantly improve. Finally, the patient's symptoms were well improved by surgery, and the postoperative pathological diagnosis was multiple IP.
Intracranial inflammatory pseudotumor is a benign disease with slow progression, but the clinical symptoms and imaging findings are not typical, there are no pathological findings, and the diagnosis is relatively difficult. Most of the cases are treated by surgical resection, and the prognosis is good after surgery.
Core Tip: Inflammatory pseudotumor, also known as inflammatory myofibroblastoma, is a nodular lesion with fibrous connective tissue proliferation accompanied by a large number of inflammatory cells. The disease can occur in any part of the body, most often in the lungs, but also in the liver, spleen, lymph nodes, and other parts, and intracranial occurrence is relatively rare, especially after craniopharyngioma resection via an extended nasal endoscopic approach. The purpose of this case report is to remind clinicians of the existence of inflammatory pseudotumors after craniocerebral surgery.