Skull Base Rep 2011; 1(2): 105-110
DOI: 10.1055/s-0031-1280739
© Thieme Medical Publishers

Inflammatory Pseudotumor of the Skull Base Involving Fissura Petrooccipitalis: A Rare Case with Challenging Diagnosis

Biao Huang1 , Hong-Jun Liu1 , Chang-Hong Liang1
  • 1Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital, Guangzhou, Guangdong, China
Further Information

Publication History

Publication Date:
07 July 2011 (online)


Inflammatory pseudotumor (IPT) is a benign entity that may present as a solid mass mimicking a malignant neoplasm. Histologically, they are composed of varying proportions of myofibroblastic spindle cells, lymphocytes, and plasma cells. Skull base IPT is rare and usually occurs in adults with no sex predilection. The skull base IPT typically presents with headache, and/or cranial nerve palsy. There is no consensus regarding treatment of skull base IPT due to its rarity. Surgical resection and corticosteroid therapy have generally been used. The preoperative diagnosis of skull base IPT is usually difficult due to its nonspecific clinical and radiologic features. We report a case of a 42-year-old woman with IPT originating from the skull base. To our knowledge, this is the first case of IPT invading fissura petrooccipitalis. When a mass in the skull base appears hypointense on T2-weighted imaging with aggressive growth and bony destruction, IPT should be considered in the differential diagnosis.


  • 1 Narla L D, Newman B, Spottswood S S, Narla S, Kolli R. Inflammatory pseudotumor.  Radiographics. 2003;  23 (3) 719-729
  • 2 Garg V, Temin N, Hildenbrand P, Silverman M, Catalano P J. Inflammatory pseudotumor of the skull base.  Otolaryngol Head Neck Surg. 2010;  142 (1) 129-131
  • 3 McKinney A M, Short J, Lucato L, SantaCruz K, McKinney Z, Kim Y. Inflammatory myofibroblastic tumor of the orbit with associated enhancement of the meninges and multiple cranial nerves.  AJNR Am J Neuroradiol. 2006;  27 (10) 2217-2220
  • 4 Maruya S, Miura K, Tada Y et al.. Inflammatory pseudotumor of the parapharyngeal space: a case report.  Auris Nasus Larynx. 2010;  37 (3) 397-400
  • 5 Batsakis J G, el-Naggar A K, Luna M A, Goepfert H. “Inflammatory pseudotumor”: what is it? How does it behave?.  Ann Otol Rhinol Laryngol. 1995;  104 (4 Pt 1) 329-331
  • 6 Coffin C M, Watterson J, Priest J R, Dehner L P. Extrapulmonary inflammatory myofibroblastic tumor (inflammatory pseudotumor). A clinicopathologic and immunohistochemical study of 84 cases.  Am J Surg Pathol. 1995;  19 (8) 859-872
  • 7 Arber D A, Weiss L M, Chang K L. Detection of Epstein-Barr Virus in inflammatory pseudotumor.  Semin Diagn Pathol. 1998;  15 (2) 155-160
  • 8 Häusler M, Schaade L, Ramaekers V T, Doenges M, Heimann G, Sellhaus B. Inflammatory pseudotumors of the central nervous system: report of 3 cases and a literature review.  Hum Pathol. 2003;  34 (3) 253-262
  • 9 Biselli R, Ferlini C, Fattorossi A, Boldrini R, Bosman C. Inflammatory myofibroblastic tumor (inflammatory pseudotumor): DNA flow cytometric analysis of nine pediatric cases.  Cancer. 1996;  77 (4) 778-784
  • 10 Lawrence B, Perez-Atayde A, Hibbard M K et al.. TPM3-ALK and TPM4-ALK oncogenes in inflammatory myofibroblastic tumors.  Am J Pathol. 2000;  157 (2) 377-384
  • 11 McCall T, Fassett D R, Lyons G, Couldwell W T. Inflammatory pseudotumor of the cavernous sinus and skull base.  Neurosurg Rev. 2006;  29 (3) 194-200
  • 12 Lu C H, Yang C Y, Wang C P, Yang C C, Liu H M, Chen Y F. Imaging of nasopharyngeal inflammatory pseudotumours: differential from nasopharyngeal carcinoma.  Br J Radiol. 2010;  83 (985) 8-16
  • 13 Lee J H, Kim K, Chung S W, Choi Y C, Lee A. A case report of inflammatory pseudotumor involving the clivus: CT and MR findings.  Korean J Radiol. 2001;  2 (4) 231-234
  • 14 Strasnick B, Vaughan A. Inflammatory pseudotumor of the temporal bone: a case series.  Skull Base. 2008;  18 (1) 49-52
  • 15 Lee D K, Cho Y S, Hong S H, Chung W H, Ahn Y C. Inflammatory pseudotumor involving the skull base: response to steroid and radiation therapy.  Otolaryngol Head Neck Surg. 2006;  135 (1) 144-148

Chang-Hong Liang

Department of Radiology, Guangdong Academy of Medical Sciences, Guangdong General Hospital

#106 Zhongshan 2nd Road, Guangzhou, Guangdong, China 510080