Extraorbital tumefactive fibroinflammatory lesions, idiopathic pseudotumors of the central skull base and sclerosing cervicitis: distinct or sole lesion?

ABSTRACT

To explore whether the terms "Tumefactive Fibroinflammatory Lesion [TFIL]", "Idiopathic Pseudotumors [IPT]"and "Sclerosing Cervicitis [SC]" represent a single or separate clinico-pathologic entities. Literature review for the non malignant infiltrative lesions of the head and neck involving the central skull base. Orbital lesions were excluded. PubMed search using combinations of the following terms pseudotumor, fibroinflammatory, non infective, non neoplastic, sclerosing, cervicitis, neck and skull base. Comparison of the definitions, incidences, etiologic factors, tissues of origin, routes of growth, clinical pictures, radiologic and histopathologic features, treatment modalities and outcomes of the cases reported under the three terms. Thirty five articles were identified describing twenty six cases of cervical Idiopathic Pseudotumors [IPT] involving the central skull base and not originating from the orbit, eight cases of Sclerosing Cervicitis and 16 cases of Tumefactive Fibroinflammatory Lesions of the head and neck. The comparison showed that the clinical, radiologic, and pathologic findings of the "Tumefactive Fibroinflammatory Lesions", "Sclerosing cervicitis" and "Idiopathic Pseudotumors" are undistinguishable. All three lesions are steroid responsive with frequent remissions and exacerbations. Surgical treatment is followed by the lowest incidence of recurrence, yet it is not feasible in every case. The terms Tumefactive Fibroinflammatory Lesions, Sclerosing Cervicitis and Idiopathic [or inflammatory] Pseudotumors describe the same clinico-pathologic entity. The role of surgery in treating those lesions reaching the skull base is limited, secondary to their infiltrative growth