Inflammatory Pseudotumor and/or Xanthoma Involving The Maxilla And Maxillary Sinus: An Unusual Case Report

Fibro inflammatory pseudotumors are histologically benign, locally destructive lesions composed of fibrovascular tissue admixed with chronic inflammatory cells. They are unencapsulated mass-like aggregates of myofibroblastic spindle cells and inflammatory cells including both B-cell and T- cell lymphocytes. Xanthomas are soft tissue benign lesions, commonly seen involving the skin or over subcutaneous tissue of tendon sheaths and extensor surfaces following minor trauma or friction. In this article, we report an unusual and interesting case which reported to our institute, in which the incisional and excisional biopsy and immunohistochemistry analysis showed varying results. In our patient, the incisional biopsy and ImmunoHistochemistry gave the impression of a Low Grade Spindle Cell tumor with features suggestive of Myofibroblastic tumor/ Inflammatory pseudo tumor. After reviewing literature and understanding the high incidence of recurrences in patients with IPT, a more aggressive approach was implemented (surgical excision with margins). The post-operative histopathology and immunohistochemistry identified the lesion as a Xanthoma (positive for CD68 and foamy histiocytes).