Objective  This work aims to present the imaging and clinical features of inflammatory myofibroblastic tumor (IMT) in the head and neck region to improve its diagnostic accuracy.

  Methods  Clinical records and computer tomography (CT) and magnetic resonance imaging (MRI) findings of 11 cases with head and neck IMT treated in Cancer Center of Sun Yat-sen University, Guangzhou, China, were retrospectively reviewed.

  Results  A total of 15 lesions were found in these cases. Of all the 11 patients, 8 showed painless masses with rapid development, 2 had face swelling, and 1 had progressive exophthalmoses. In this study, 72.7% (8/9) of the patients were diagnosed to have malignant tumors before the surgery. Of all the patients, 6 underwent MRI scans before surgery, 3 underwent CT scans, and 2 received both MRI and CT scans. Of the 15 lesions found in our study, 13 (86.7%) were ill-defined and suffered involvements of the adjacent muscles, whereas 7 (46.7%) had osseous invasions. Among the patients, 3 had a peri-neural infiltration, 2 suffered from invasion through both foramen rotundum and foramen ovale, and 1 was invaded through the optic canal. As shown in the plain film CT scans with even and uneven images, the IMT appeared slightly hypodense with respect to adjacent muscles and then presented a strong enhancement after contrast-enhanced scanning. Calcification or necrosis is uncommon. The MRI features showed heterogeneously mild hypo-intensity on T₁-weighted images, heterogeneously low signal on T₂-weighted images, and strong enhancement on contrast-enhanced T1WI.

  Conclusion  IMT in the head and neck region exhibits a high local invasiveness but does not metastasize. It has some imaging characteristics that are commonly found in malignant tumors. MRI features help distinguish this tumorfrom other kinds of neoplasm.