Corticodependent and recurrent inflammatory pseudo tumor. Analysis of cases and review.

Jaime Sanz-Cánovas, Gonzalo Lendínez-Sánchez, Elisa Prieto-Sánchez, Luis Vicioso-Recio, Antonio Gutiérrez-Cardo, Esther Izurrategui-Hidalgo, Sebastián Palacios-Rodríguez, José Miguel Peláez-Angulo, Guillermo Ropero-Luis, Iván Pérez-de-Pedro, Ricardo Gómez-Huelgas, Fernando Salgado-Ordóñez

Journal: The American journal of the medical sciences 2024;367(2):135-141

PMID: 37980969

Full Text on Elsevier Science View on PubMed

Abstract

Inflammatory pseudo tumor (IP) is an infrequent process with benign evolution in most cases whose etiology and pathogenesis are unknown. It usually affects young men and children, in whom the macroscopic lesion can mimic a malignant process, which is ruled out after biopsy. Therefore, the diagnosis of certainty is histological and treatment consists of corticosteroids, leaving resection for cases in which biopsy is not possible or in which it produces local complications. We present a case of an inflammatory pseudo tumor with special corticodependence that began as a long-term periodic fever and splenic focal lesion that required splenectomy for its diagnosis and that, after decreasing the corticosteroid regimen, presented recurrences at the cerebellar and systemic level requiring the association of various immunosuppressants and rituximab to achieve remission. As a result of this case, we have performed an analysis of all the pseudo tumors diagnosed in adults in the hospitals of the province of Malaga, and it has been compared with that described in the bibliography.

Address: Clinical Management Unit of Internal Medicine, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, University of Málaga, Málaga, Spain. Electronic address: [email protected].; Clinical Management Unit of Medical Oncology, Hospital Regional Universitario de Málaga, Málaga, Spain.; Department of Pathology, Hospital Regional Universitario de Málaga, Málaga, Spain.; Department of Pathology, Hospital Clínico Universitario Virgen de la Victoria de Málaga, Málaga, Spain.; Department of Nuclear Medicine. Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica, Málaga, Spain.; Department of Pathology, Hospital de Antequera, Málaga, Spain.; Department of Pathology, Hospital de la Serranía, Ronda, Málaga, Spain.; Department of Pathology, Hospital de la Axarquía, Vélez-Málaga, Málaga, Spain.; Department of Internal Medicine, Hospital de la Serranía, Ronda, Spain.; Clinical Management Unit of Internal Medicine, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, University of Málaga, Málaga, Spain.; Clinical Management Unit of Internal Medicine, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, University of Málaga, Málaga, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, Madrid, Spain.

DOI: 10.1016/j.amjms.2023.11.010

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MeSH Terms: Adult, Male, Child, Humans, Immunosuppressive Agents, Neoplasms, Splenectomy, Adrenal Cortex Hormones, Rituximab