Inflammatory pseudotumor of the fossa pterygopalatina: diagnosis and treatment

Pseudotumor is a term used to describe a space-occupying inflammatory lesio n of unknown etiology that clinically simulates a neoplastic process. Pseud otumors of the fossa pterygopalatina and fossa infratemporalis are very rar e. In this paper, we describe a patient who developed a pseudotumor in the left fossa pterygopalatina, secondary to an unclassified autoimmune disease , which caused progressive left-sided facialdynia and swelling. The tumor w as detected with somatostatin receptor scintigraphy. The lesion was refract ory to steroids, also in combination with azathioprine, as well as to surgi cal intervention. An excellent clinical response was observed after cyclosp orine was added. This case is presented here in order to draw attention to the use of somatostatin receptor scintigraphy as a diagnostic tool in visua lizing pseudotumors and to document a case that responded excellently to tr eatment with a combination of low-dose cyclosporine and steroids. (C) 2000 Elsevier Science B.V. All rights reserved.