An inflammatory pseudotumour of the larynx: a case report and literature review of an unusual tumour

Abstract

Background: Inflammatory pseudotumour (IPT) is a rare benign pseudoneoplastic proliferation of unknown etiology, often showing locally aggressive behaviour. Conflicting theories about exaggerated response to injury versus true neoplastic origin have been suggested.

Methods: We report a case of laryngeal pseudotumour in a 73-year-old man presenting with hoarseness and slowly progressive dyspnea and a short review of the English language literature on the subject.

Results: Management consisted of midline vertical thyrotomy, excision of the tumour, and a temporary tracheotomy. No recurrence observed eight months postoperatively.

Conclusions: Laryngeal IPT is extremely rare, and it may easily be misinterpreted as a malignant tumour. Conservative excision and anti-inflammatory therapy are advocated, since its general behaviour is benign.

Keywords: inflammatory myofibroblastic tumour; inflammatory pseudotumour; laryngeal neoplasms; plasma cell granuloma.

Figure 1:. Coronal T1-weighted MRI reveals thickening of the left vocal cord (black arrow).

Figure 2:. Histologically, the tumor is composed of spindle-shaped myofibroblasts in collagenous and inflammatory background (hematoxylin-eosin stain, original magnification ×400).

Figure 3:. Reactivity in the cytoplasm of the myofibroblasts with smooth muscle actin (original magnification ×400).

Figure 4:. Grossly, the tumor was firmly attached to the left true vocal cord and presented to be nodular, measuring in diameter 1.7 × 1.1 × 0.7 cm.