Calcifying pseudoneoplasms of the neuraxis (CAPNON): clinical features and therapeutic options

Stienen, Martin N.; Abdulazim, Amr; Gautschi, Oliver; Schneiderhan, Timo Marcel; Hildebrandt, Gerhard; Lücke, Sebastian

doi:10.1007/s00701-012-1502-2

Cited by 39 publications

(54 citation statements)

References 18 publications

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“…The frequent adjacent granulomatous and inflammatory reaction along with an indolent course and a generally good prognosis support a benign or reactive rather than neoplastic process . Of the 65 cases of CAPNON that we identified in the literature, only one case presented with two separate lesions diagnosed 8 years apart in the same individual . The remaining 64 cases were solitary.…”

Section: Introductionmentioning

confidence: 77%

Multiple calcifying pseudoneoplasms of the neuraxis (MCAPNON): Distinct entity, CAPNON variant, or old neurocysticercosis?

Abdaljaleel

Mazumder

et al. 2016

Neuropathology

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We report a case of multiple calcifying pseudoneoplasms of the neuraxis (MCAPNON) with associated multifocal perivascular microcalcifications and vascular calcinosis. Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a very rare condition that may arise in extra-axial and occasionally, in intra-axial locations. Moreover, it is nearly always a solitary mass with only one case with two lesions reported. While the etiology and pathogenesis of CAPNON remains unclear, the histopathology findings of this entity have been well described. We report a case of a 62-year-old woman with 18 calcifying radiologic lesions involving bilateral cerebral hemispheres. Histologically, these lesions have features similar to that reported for CAPNON, including nodular calcification with fibro-osseous components and peripheral histiocytic reaction. The patient had a poorly documented diagnosis of neurocyticercosis 32 years prior, although without tissue confirmation. The lack of detectable cysticercus serum antibody titers, and absence of residual larval or cyst wall tissue render multifocal calcific involution of that parasite unprovable although still plausible. We also raise the possibility of a blood-brain barrier derangement and/or a metabolic disorder as an alternative etiology. Whether this case of MCAPNON shares the same pathogenesis as the usual solitary CAPNON is unclear.

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Section: Introductionmentioning

confidence: 77%

Multiple calcifying pseudoneoplasms of the neuraxis (MCAPNON): Distinct entity, CAPNON variant, or old neurocysticercosis?

Abdaljaleel

Mazumder

et al. 2016

Neuropathology

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“…Resection has been proposed as the most appropriate treatment for CAPNON. 3 However, large lesions as in our case may not be amenable to complete resection. Owing to the lack of larger series, the value of complete vs partial resection remains speculative.…”

Section: Sectionmentioning

confidence: 62%

“…It has been described in patients aged from 6 to 68 years with a preponderance of males. 3 The clinical symptoms and signs vary and depend on the localization of the mass, with seizures as the most frequent symptom if the lesion is located intracranially.…”

Section: Sectionmentioning

confidence: 99%

Clinical Reasoning: A 30-year-old woman with recurrent seizures and a cerebral lesion progressing over 2 decades

et al. 2014

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“…[49] CT studies showed that these lesions are a hyperdense lesion while MR studies demonstrated hypointense T1- and T2-weighted images with limited edema and contrast enhancement. [1] Differential diagnoses include meningioma, granulomatous lesions, astrocytoma with calcification, oligodendrogliomas, and hamartomas.…”

Section: Discussionmentioning

confidence: 99%

Intradural calcifying pseudoneoplasm of the neuraxis presenting as a cauda equina syndrome

Lopes¹,

Brock²,

Martins³

et al. 2016

Surg Neurol Int

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Background:Calcifying nonneoplastic pseudoneoplasms of the neuraxis (CAPNON) have been reported in 59 cases in literature, however, they rarely involve the spinal cord. Owing to the advances in immunohistochemical markers, their structure and origin are better understood now.Case Report:We present the case of a 72-year-old female who had longstanding history of low back pain that exacerbated 20 days prior to the presentation to the emergency room with a frank cauda equina syndrome. The lumbar computed tomography scan showed a hyperdense lesion, suggestive of calcified tumor, whereas the magnetic resonance imaging revealed a hypointense lesion on theT1 and T2-weighted images, without contrast enhancement or edema on fluid-attenuated inversion recovery. She underwent an emergent L2-L4 laminectomy and L3-L4 discectomy with resection of L2 intradural tumor, following which she regained normal function.Conclusion:A 72-year-old female presented with a cauda equina syndrome attributed to an L2 intradural CAPNON. Following gross total resection, the patient was neurologically intact.

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Calcifying pseudoneoplasms of the neuraxis (CAPNON): clinical features and therapeutic options

Abstract: Calcifying pseudoneoplasms are rare benign lesions of the CNS of yet unknown origin. Because of the increasing number of reports, this clinical entity should be taken into consideration in the differential diagnosis of intracranial and intraspinal calcified lesions.

Cited by 39 publications

References 18 publications

Multiple calcifying pseudoneoplasms of the neuraxis (MCAPNON): Distinct entity, CAPNON variant, or old neurocysticercosis?

Multiple calcifying pseudoneoplasms of the neuraxis (MCAPNON): Distinct entity, CAPNON variant, or old neurocysticercosis?

Clinical Reasoning: A 30-year-old woman with recurrent seizures and a cerebral lesion progressing over 2 decades

Intradural calcifying pseudoneoplasm of the neuraxis presenting as a cauda equina syndrome

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