Inflammatory Pseudotumor of the Ulnar Nerve Mimicking a Malignant Peripheral Nerve Sheath Tumor: A Radiologic Puzzle

Abstract

Inflammatory pseudotumor (IPT) of a peripheral nerve is a rare non-neoplastic tumefactive inflammatory condition, often mimicking malignancy. The etiology of this condition is still unknown. Clinically and radiologically, the lesion can mimic a malignant tumor. This case report represents, as far as we know, the first publication describing the ultrasonography findings and the results of advanced dynamic contrast-enhanced magnetic resonance imaging (MRI) and diffusion-weighted MRI of IPT in a peripheral nerve. Suspicion of this entity on imaging can speed up the definitive diagnosis and potentially avoid overly radical treatment.

Keywords

inflammatory pseudotumor of a peripheral nerve - peripheral nerve pseudotumor - inflammatory pseudotumor magnetic resonance imaging - inflammatory pseudotumor ultrasonography

Publikationsverlauf

Artikel online veröffentlicht:
15. Oktober 2024

• References

• 1 Golan JD, Jacques L. Nonneoplastic peripheral nerve tumors. Neurosurg Clin N Am 2004; 15 (02) 223-230
• 2 Mauermann ML, Scheithauer BW, Spinner RJ. et al. Inflammatory pseudotumor of nerve: clinicopathological characteristics and a potential therapy. J Peripher Nerv Syst 2010; 15 (03) 216-226
• 3 Patnana M, Sevrukov AB, Elsayes KM, Viswanathan C, Lubner M, Menias CO. Inflammatory pseudotumor: the great mimicker. AJR Am J Roentgenol 2012; 198 (03) W217–W227
• 4 Siemion K, Reszec-Gielazyn J, Kisluk J, Roszkowiak L, Zak J, Korzynska A. What do we know about inflammatory myofibroblastic tumors? A systematic review. Adv Med Sci 2022; 67 (01) 129-138
• 5 Pérez-López C, Gutiérrez M, Isla A. Inflammatory pseudotumor of the median nerve. Case report and review of the literature. J Neurosurg 2001; 95 (01) 124-128
• 6 Ferri A, Bergonzani M, Varazzani A, Sesenna E. Inflammatory pseudotumor of the infraorbital nerve. J Craniofac Surg 2016; 27 (06) e554-e557
• 7 El Demellawy D, Bain J, Algawad H, Provias JP. Inflammatory pseudotumor of the peroneal nerve: case report and literature review. Ann Diagn Pathol 2008; 12 (01) 44-47
• 8 Drapé J-L. Advances in magnetic resonance imaging of musculoskeletal tumours. Orthop Traumatol Surg Res 2013; 99 (01) S115-S123
• 9 Sakuda T, Furuta T, Johan MP, Arihiro K, Adachi N. Extraskeletal Ewing sarcoma attached to the ulnar nerve: a case report. Int J Surg Case Rep 2021; 80: 105676
• 10 Sita-Alb L, Sobec R, Fodor L. Primary B lymphoma tumor of the ulnar nerve. Case report. Med Pharm Rep 2019; 92 (03) 303-307
• 11 Mattiassich G, Schubert H, Hutarew G, Wechselberger G. A rare manifestation of sarcoidosis with sensomotoric neuropathy of the ulnar nerve as the only symptom. BMJ Case Rep 2012; 2012 (01) bcr2012007430
• 12 Baptista B, Casian A, Gunawardena H, D'Cruz D, Rice CM. Neurological manifestations of IgG4-related disease. Curr Treat Options Neurol 2017; 19 (04) 14
• 13 Sen D, Satija L, Chatterji S, Majumder A, Gupta A, Kumar A. Ultrasonography and magnetic resonance imaging of ulnar nerve abscess in leprosy. Med J Armed Forces India 2016; 72 (01) 78-81
• 14 Tagliafico AS, Isaac A, Bignotti B, Rossi F, Zaottini F, Martinoli C. Nerve tumors: what the MSK radiologist should know. Semin Musculoskelet Radiol 2019; 23 (01) 76-84
• 15 Aru MG, Davis JL, Stacy GS. et al. Beyond schwannomas and neurofibromas: a radiological and histopathological review of lesser-known benign lesions that arise in association with peripheral nerves. Skeletal Radiol 2023; 52 (04) 649-669
• 16 Tovmassian D, Abdul Razak M, London K. The role of [¹⁸F]FDG-PET/CT in predicting malignant transformation of plexiform neurofibromas in neurofibromatosis-1. Int J Surg Oncol 2016; 2016: 6162182