Diagnosis and treatment of inflammatory myofibroblastic tumor of maxillry sinus

Abstract

Objective To investigate the clinical feature and diagnosis of inflammatory myofibroblastic tumor(IMT) of maxillary sinus. Methods Six patients of IMT of maxillary treated in Department of Otorhinolaryngology-Head and Neck Surgery, the First Affiliated Hospital of Anhui Medical University were analyzed retrospectively from January 2010 to January 2014. Of the 6 patients, all tumors were located in maxillary sinus. There were 4 male patients and 2 female patients with the age from 38 to 81 years, the median age was 58.5 years. Six patients were characterized by nasal congetion, headache, nasal blee-ding and other specisic clinical manesestations, All patients had been given operation and recovered well. Results After a follow-up of 8-47 months, one recurrent and transformed to inflammatory myofibroblastic sarcoma after 18 months of operation. The other 5 patients had no sign of recurrence. CT and MRI showed that the tumor were all of soft tissue sources, of which 5 patients with different degree of bone destruction, and 3 patients with surrounding muscle tissue invaded. The finial diagnosis depended on pathology. Histologically, the tumor was mainly composed of spindle cells and chronic inflammatory cells. Immunohistochemical stains demonstrated SMA was positive. Conclusions IMT of maxillary sinus is rare. It lacks the specific clinical manefestations. The finial diagnosis depends on pathology. It is lower-grade malignant degree tumor. In therapy, we should avoid excessive operation, although surgery operation is basic treatment method. Besides surgery, hormone and irradiation therapy is recommended in some circumstances. Key words: Maxillary sinus neoplasms; Diagnosis, differential; Nasal surgical procedures; Granuloma, plasma cell