FIBROINFLAMMATORY PSEUDOTUMOR OF THE EAR - A LOCALLY DESTRUCTIVE BENIGN LESION

We describe three cases of a fibroinflammatory pseudotumor (tumefactiv e fibroinflammatory lesion) of the middle and inner ear. The patients presented with total deafness in the affected ear and no response to c aloric stimulation. The computed tomographic pattern showed destructio n of inner ear structures and a typical widening of parts of the labyr inth. Magnetic resonance imaging performed in all three patients showe d an extension greater than expected based on computed tomographic ima ges of both areas of destruction, as well as areas of radiologic norma lity. An enhancing mass was seen in the inner ear with a characteristi c extension into both the internal auditory canal and the middle ear. A transotic approach or subtotal petrosectomy was used to remove the t umor in all three cases. Although histologically benign, these tumors are locally destructive and, as such, behave like a neoplastic lesion. They are composed of fibrovascular tissue admired with chronic inflam matory cells. To our knowledge, this is the first report on pseudotumo rs of the middle ear, inner ear, and internal auditory canal. Inflamma tory pseudotumor used to be a somewhat confusing term for a recognized entity of unknown origin. It is likely that infection is an important contributing factor in the development of these lesions. Although sur gical removal seems to be the treatment of choice, no clear judgment o f its prognosis can be made owing to the rarity of this tumor.