Intracranial Inflammatory Myofibroblastic Tumor: A Review of 49 cases.

Inflammatory Myofibroblastic Tumor (IMT) is a rare pathologic entity that was first described in 1973. This lesion is most commonly found in the lungs, but other organs' involvement has also been reported. Intracranial location of Inflammatory Myofibroblastic Tumor is rare, and the first case was reported in 1980. An intriguing fact about the intracranial IMT is its resemblance with meningioma on clinical presentation and neuroimaging. We came across a case of intracranial Inflammatory Myofibroblastic Tumor (IIMT) in a 27-year-old male who presented with recurrent episodes of seizures and was diagnosed as meningioma on neuroimaging. The lesion did not subside with medical management and kept on progressing in size. The patient had to undergo surgery, and diagnosis of Inflammatory Myofibroblastic Tumor was ascertained on histopathology. This 'surprise' diagnosis prompted us to review the literature on all cases of IIMTs reported to date to better understand the entity and its implications. In this review article, we present our observations regarding various studied parameters, including patient profile, clinical presentation, site of involvement, focality of the lesion, special associations, and lines of management of the 49 published cases of IIMTs.

Intracranial Inflammatory Myofibroblastic Tumor: A Review of 49 cases

Inflammatory Myofibroblastic Tumor (IMT) is a rare pathologic entity that was first described in 1973. This lesion is most commonly found in the lungs, but other organs' involvement has also been reported. Intracranial location of Inflammatory Myofibroblastic Tumor is rare, and the first case was reported in 1980. An intriguing fact about the intracranial IMT is its resemblance with meningioma on clinical presentation and neuroimaging. We came across a case of intracranial Inflammatory Myofibroblastic Tumor (IIMT) in a 27-year-old male who presented with recurrent episodes of seizures and was diagnosed as meningioma on neuroimaging. The lesion did not subside with medical management and kept on progressing in size. The patient had to undergo surgery, and diagnosis of Inflammatory Myofibroblastic Tumor was ascertained on histopathology. This 'surprise' diagnosis prompted us to review the literature on all cases of IIMTs reported to date to better understand the entity and its implications. In this review article, we present our observations regarding various studied parameters, including patient profile, clinical presentation, site of involvement, focality of the lesion, special associations, and lines of management of the 49 published cases of IIMTs.

Perianal Block: Is It as Good as Spinal Anesthesia for Closed Hemorrhoidectomies?

BACKGROUND AND AIMS: This study compared if perianal block using ropivacaine and dexmedetomidine was as good as spinal anesthesia (SA) using bupivacaine (heavy) for closed hemorrhoidectomies. METHODS: A prospective randomized study was conducted in sixty patients who underwent closed hemorrhoidectomy. Thirty patients of Group A received SA. Thirty patients in Group B received local perianal block. Patients were evaluated for onset of the block, total pain-free period, and time to ambulation. Patient satisfaction in terms of pain during injection and satisfaction with the anesthesia technique was assessed after 2-week telephonically. Data were statistically analyzed using unpaired t-test for the continuous variables and Fischer's exact test for categorical variables. RESULTS: Onset of anesthesia was significantly earlier in Group B, mean (standard deviation [SD]) value being 3.17 (1.28) min as compared to Group A, 6.24 (4.28) min (P = 0.0004). Total pain-free period (mean [SD]) in minute was longer in Group B, 287 (120) min as compared to Group A, 128 (38) min. Time to ambulation was significantly earlier in Group B, 22.83 (29.32) min as compared to Group A 302 (92.41) min. Pain during injection between the two groups was comparable. However, more patients in Group B (60%) were satisfied with the anesthesia technique as compared to Group A (27.5%). CONCLUSION: Perianal block for hemorrhoidectomy with ropivacaine 0.2% using dexmedetomidine as an adjuvant is an effective and reliable technique which is as effective as SA. It provides prolonged postoperative analgesia and early ambulation.