title: Bilateral inflammatory myofibroblastic tumor mastoiditis.
abstract: BACKGROUND
  Inflammatory myoblastic tumors (IMTs) are rare, mesenchymal neoplasms most commonly located in areas of previous inflammation. In the temporal bone, these tumors typically present as solitary, space-occupying lesions that clinically resemble chronic otitis media.
  
  
  METHODS
  We present a case of bilateral IMTs with facial nerve involvement, sigmoid sinus thrombosis, leptomeningeal enhancement, and seizures.
  
  
  CONCLUSIONS
  This case demonstrates the need for a high index of suspicion of IMT when imaging reveals bilateral mastoid opacification. These tumors are more aggressive than their orbital counterparts and require multimodality therapy to prevent recurrence and alleviate severe neurotologic symptoms.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Kansas Hospital, Kansas City, Kansas.
authors.forename: Brian
authors.initials: B
authors.lastname: Rodgers
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Kansas Hospital, Kansas City, Kansas.
authors.forename: Vidur
authors.initials: V
authors.lastname: Bhalla
authors.affiliation: Department of Pathology and Laboratory Medicine, University of Kansas Hospital, Kansas City, Kansas.
authors.forename: Da
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, University of Kansas Hospital, Kansas City, Kansas.
authors.forename: Wissam
authors.initials: W
authors.lastname: El Atrouni
authors.affiliation: Department of Radiation Oncology, University of Kansas Hospital, Kansas City, Kansas.
authors.forename: Fen
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Neurology, University of Kansas Hospital, Kansas City, Kansas.
authors.forename: Jayashree
authors.initials: J
authors.lastname: Sundararajan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Kansas Hospital, Kansas City, Kansas.
authors.forename: James
authors.initials: J
authors.lastname: Lin
mesh_terms: D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005158:Facial Paralysis / Q000175:diagnosis / Q000209:etiology; D005500:Follow-Up Studies; D006104:Granuloma, Plasma Cell / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008416:Mastoid / Q000473:pathology* / Q000601:surgery; D008417:Mastoiditis / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D035583:Rare Diseases; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: bilateral mastoiditis; facial nerve paralysis; inflammatory myofibroblastic tumor; inflammatory pseudotumor; sigmoid sinus thrombosis