Extradural petromastoid calcifying pseudoneoplasm of the neuraxis (CAPNON): Case report and literature review

Nussbaum, Eric S.; Hilton, Christopher; Defillo, Archie; McDonald, William C.; Passe, Theodore J.; Kallmes, Kevin M.; Nussbaum, Leslie A.

doi:10.1016/j.clineuro.2018.01.010

Cited by 16 publications

(19 citation statements)

References 25 publications

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“…In the brain, there may be involvement of the parenchyma, ventricles, corpus callosum, dura, pineal gland, arachnoid cisterns, cerebellum, and foramen magnum 2,7‐11,15‐23 . In the neck (facial bones, skull base, craniovertebral junction), reported locations include the orbits, sella, clivus, temporal bone, cranial nerves, skull base foramina, and craniocervical junction 24‐28 . In the spine, lesions have been reported at the cervical, thoracic, lumbar and sacral levels, with variable involvement of the spinal cord, facet joints, intervertebral disc, dura, and neural foramina 2,7‐11,29‐33 .…”

Section: Discussionmentioning

confidence: 99%

New insights into calcifying pseudoneoplasm of the neuraxis (CAPNON): a 20‐year radiological–pathological study of 37 cases

Eschbacher

Paolini

et al. 2020

Histopathology

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New insights into calcifying pseudoneoplasm of the neuraxis (CAPNON): a 20-year radiological-pathological study of 37 cases Aims: Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare entity that can occur anywhere within the central nervous system. Histologically, CAPNON has been characterised as a benign, calcified, fibro-osseous lesion with a characteristic chondromyxoid fibrillary matrix with dense calcification and varying degrees of spindle, epithelioid, fibrous, meningothelial and giant cells. The underlying aetiology of CAPNON is controversial and incompletely understood. The aim of this study was to perform a comprehensive radiological and histological review to further characterise this entity. Methods and results: In this article, we review our institutional 20-year experience including 37 cases of CAPNON with detailed pathological analysis, evaluation of concurrent lesions, correlation with radiological imaging, and critical review of the literature. The classic histological finding of chondromyxoid matrix was present in one-third of cases. Underlying or dual pathologies were frequent, and included diverse underlying conditions. Radiologically, dense calcification and dural attachment were the most common features. Enhancement was often low, but was more prominent in the setting of inflammatory changes, aggressive growth, and dual pathology. Conclusion: Our results suggest that CAPNON represents a spectrum of reactive processes that can arise in association with diverse underlying pathologies, including inflammatory, degenerative, vascular and neoplastic lesions.

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Section: Discussionmentioning

confidence: 99%

New insights into calcifying pseudoneoplasm of the neuraxis (CAPNON): a 20‐year radiological–pathological study of 37 cases

Eschbacher

Paolini

et al. 2020

Histopathology

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“…4,[7][8][9][10][11][13][14][15][16][17][18][19][20][21][22][23][24] All 24 patients (including our previously unpublished case) were symptomatic, with 11 (45.8%) patients presenting with cranial neuropathies (Table 1). [7][8][9]13,16,20 One patient (Case 5) was managed conservatively, 13 and one patient (Case 22) underwent a biopsy of the lesion, 14 while the rest underwent resection of the lesion. Analysis of patients with documented extents of resection revealed that 10 patients underwent gross total resection and 6 underwent subtotal resection of CAPNONs.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Among 11 patients with cranial neuropathies, the outcomes of cranial neuropathies were documented in 6 patients. 7,9,16,20 Two…”

Section: Literature Reviewmentioning

confidence: 99%

“…patients had a sacrifice of the CN function with surgical approaches (Cases 1 and 21), 7,20 while the remaining four patients (Cases 9, 13, 14, and 24) remained stable with persistent cranial neuropathies. 9,16 Another patient (Case 15) had new CN X palsy postoperatively, which was responsive to medical management.…”

Section: The Canadian Journal Of Neurological Sciencesmentioning

confidence: 99%

“…17 Jugular foramen CAPNONs were reported in three other cases, of which two cases were not followed clinically (Cases 6 and 21). 13,20 The third patient (Case 2) initially underwent an intralesional excision and had disease progression at 3 years requiring repeat surgical intervention. 13 Notably, this was the only reported case of CAPNON recurrence in the series of 24 patients.…”

Section: The Canadian Journal Of Neurological Sciencesmentioning

confidence: 99%

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Skull Base Calcifying Pseudoneoplasms of the Neuraxis: Two Case Reports and a Systematic Review of the Literature

Yang

Reddy

Ellenbogen

et al. 2019

Can. J. Neurol. Sci.

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ABSTRACT:Background:Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare tumefactive lesion. CAPNONs can mimic calcified meningiomas at the skull base.Methods:Here, we report two cases of CAPNON and present a systematic review of the literature on skull base CAPNONs, to compare CAPNONs with calcified meningiomas.Results:Case 1: A 57-year-old man presented with right-sided lower cranial neuropathies and gait ataxia. He underwent a subtotal resection of a right cerebellopontine angle lesion, with significant improvement of his gait ataxia. However, his cranial neuropathies persisted. Pathological examination of the lesion was diagnostic of CAPNON, with the entrapped nerve fibers identified at the periphery of the lesion, correlating with the patient’s cranial neuropathy. Case 2: A 70-year-old man presented with progressive headache, gait difficulty, and cognitive impairment. He underwent a frontotemporal craniotomy for a near-total resection of his right basal frontal CAPNON. He remained neurologically stable 7 years after the initial resection without evidence of disease recurrence. We analyzed 24 reported CAPNONs at the skull base in our systematic review of the literature. Cranial neuropathies were present in 11 (45.8%) patients. Outcomes regarding cranial neuropathies were documented in six patients: two had sacrifice of the nerve function with surgical approaches and four had persistent cranial neuropathies.Conclusion:While CAPNON can radiologically and grossly mimic calcified meningiomas, they are two distinctly different pathologies. CAPNONs located at the skull base are commonly associated with cranial neuropathies, which may be difficult to reverse despite surgical intervention.

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Surgically treated intracranial supratentorial calcifying pseudoneoplasms of the neuraxis (CAPNON) with drug-resistant left temporal lobe epilepsy: A case report and review of the literature

Tanoue

Uda

Nakajo

et al. 2019

Epilepsy & Behavior Case Reports

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Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare pathological lesions that can present anywhere in the central nervous system. Symptoms vary depending on the location, though they often include seizures, especially in intracranial and supratentorial lesions. A case of intracranial supratentorial CAPNON presenting with drug-resistant left temporal lobe epilepsy is reported. The patient had a history of drug-resistant focal seizures for over 36 years. The lesion was located in the left mesial temporal lobe, but hippocampal sclerosis and hippocampal invasion were not apparent. The lesion was removed without hippocampectomy, and the patient has been seizure-free for one year.

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Extradural petromastoid calcifying pseudoneoplasm of the neuraxis (CAPNON): Case report and literature review

Cited by 16 publications

References 25 publications

New insights into calcifying pseudoneoplasm of the neuraxis (CAPNON): a 20‐year radiological–pathological study of 37 cases

New insights into calcifying pseudoneoplasm of the neuraxis (CAPNON): a 20‐year radiological–pathological study of 37 cases

Skull Base Calcifying Pseudoneoplasms of the Neuraxis: Two Case Reports and a Systematic Review of the Literature

Surgically treated intracranial supratentorial calcifying pseudoneoplasms of the neuraxis (CAPNON) with drug-resistant left temporal lobe epilepsy: A case report and review of the literature

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