Postcricoid inflammatory myofibroblastic tumor (inflammatory pseudotumor) in a 10-year-old girl

Inflammatory myofibroblastic tumor (IMT) is a benign spindle cell tumor of disputed nosology and unknown etiology that occasionally presents in the head and neck but is known to occur throughout the body in patients of all ages. IMT is identified by several alternative names in the literature; inflammatory pseudotumor and plasma cell granuloma are among the most prominent. We present a case of IMT arising in the postcricoid region of the hypopharynx in a 10-year-old girl and review the literature of IMT involving the head and neck. To the best of our knowledge, this is the first report of an IMT arising in this location. The patient was treated with endoscopic surgical excision and remains free of disease 2 years following the initial surgical resection. Histologically, the differential diagnosis of IMT includes both benign and malignant neoplasms, making frozen section interpretation challenging. Highlighting this is a case report wherein the presumptive frozen section diagnosis was interpreted as rhabdomyosarcoma, while permanent histology was consistent with IMT. Therefore, surgical decisions based purely on a frozen section diagnosis of malignancy may result in inappropriate and overly aggressive surgical treatment.