Journal Information
Vol. 27. Issue 6.
Pages 291-295 (November - December 2016)
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Vol. 27. Issue 6.
Pages 291-295 (November - December 2016)
Caso clínico
Pseudotumor inflamatorio gigante de la base del cráneo
Giant inflammatory pseudotumor of the cranial base
Rodrigo Carrasco-Moroa,
Corresponding author
rocamo@gmail.com

Autor para correspondencia.
, Juan Martínez-San Millánb, Héctor Pianc
a Servicio de Neurocirugía, Hospital Universitario Ramón y Cajal, Madrid, España
b Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, España
c Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Madrid, España
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Resumen

El pseudotumor inflamatorio (PTI) es una entidad no neoplásica, de etiología desconocida, caracterizada por la proliferación de un infiltrado inflamatorio policlonal sobre un estroma de tejido conjuntivo. La afectación del sistema nervioso es infrecuente y puede suponer un reto diagnóstico y terapéutico incluso para el clínico más experimentado. Presentamos el caso de una mujer de 56años diagnosticada de una masa gigante, infiltrante, centrada en el seno cavernoso izquierdo, que experimentó una rápida mejoría clínica y radiológica tras la instauración de tratamiento con esteroides. La biopsia de la lesión fue diagnóstica de PTI. Tras la retirada del tratamiento, se evidenció una progresión de un pequeño resto lesional orbitario. El inicio de tratamiento con ciclofosfamida indujo una remisión completa de la enfermedad, que ha permanecido estable durante 6años de seguimiento.

Palabras clave:
Pseudotumor inflamatorio
Granuloma de células plasmáticas
Seno cavernoso
Base del cráneo
Abstract

The inflammatory pseudotumour (IPT) is a non-neoplastic entity of unknown origin, and is characterised by a proliferation of connective tissue and a polyclonal inflammatory infiltrate. Central nervous system involvement is uncommon, and usually represents a diagnostic and therapeutic challenge even for the experienced clinician. This reports deals with the case of a 56year-old woman diagnosed with a giant, infiltrating mass centred in the left cavernous sinus, who had a rapid clinical and radiological response to steroid therapy. Biopsy specimens were diagnostic for IPT. The progression of a small orbital residual lesion was detected after steroid withdrawal. Treatment with cyclophosphamide induced a complete response that remains stable after six years of follow-up.

Keywords:
Inflammatory pseudotumour
Plasma cell granuloma
Cavernous sinus
Skull base

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