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The great mimicker: a rare case of head and neck inflammatory pseudotumour in the presence of human immunodeficiency virus

Published online by Cambridge University Press:  20 November 2015

H Ramotar*
Affiliation:
Department of ENT Surgery, Frimley Park Hospital, Guildford, UK
L Cheung
Affiliation:
Department of ENT Surgery, Frimley Park Hospital, Guildford, UK
L Pitkin
Affiliation:
Department of ENT Surgery, Royal Surrey County Hospital, Guildford, UK
*
Address for correspondence: Dr Haripriya Ramotar, 38 Leith Road, Wood Green, London N22 5QA, UK E-mail: p_ramotar@hotmail.com

Abstract

Background:

Inflammatory pseudotumours of the head and neck are rare. A connection has been made between inflammatory pseudotumours and human immunodeficiency virus positivity.

Case report:

This paper reports a case of an inflammatory pseudotumour presenting with a lesion in the left tonsil and left cervical lymph node in a 49-year-old human immunodeficiency virus positive patient. A histological diagnosis was obtained after biopsy and serial radiological imaging.

Conclusion:

Diagnostic uncertainties can lead to unnecessary surgery. It is important to recognise the clinical, radiological and histological indicators of an inflammatory pseudotumour to enable a timely diagnosis and arrange appropriate treatment. In patients with co-morbidities causing immunocompromise, the potential diagnosis of an inflammatory pseudotumour should be considered. This is especially the case in human immunodeficiency virus patients, as inflammatory pseudotumours have been associated with immune reconstitution inflammatory syndrome, which can manifest up to several years after the initiation of, or change in, antiretroviral therapies.

Type
Clinical Record
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented at the 148th Semon Club meeting, 17 November 2014, London, UK.

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