Fibro-osseous lesions involving the brain: MRI

Da, Shrier; D, Melville; Millet, D; Jiang, Qian; C, Nelson; Pilcher, Webster H.; Jm, Powers

doi:10.1007/s002340050697

Cited by 40 publications

(19 citation statements)

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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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“…The appearance of CAPNONs on MRI has been described as a hypointensity on T1- and T2-weighted images with minimal linear internal or partial rim of contrast enhancement [7]. Surrounding brain edema (hyperintensity on T2) is very uncommon and may represent biological activity or tumor progression [2, 8]. In our patient, the presence of several intra-axial calcified lesions raised suspicion of multiple cavernous malformations, although genetic screening for KRIT-1 and CCM-2 mutations was negative.…”

Section: Discussionmentioning

confidence: 99%

Multiple Calcifying Pseudoneoplasms of the Neuraxis

Brasiliense

Dickson

Nakhleh

et al. 2017

Cureus

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Calcifying pseudoneoplasms of the neuraxis (CAPNONs) are extremely rare tumors that are frequently misdiagnosed and overlooked by clinicians. To date, only 40 intracranial lesions have been reported, and in all instances, they were found as a solitary calcified mass. To our knowledge, the current case report is the first to illustrate the development of multiple intraaxial CAPNONs and shed more light on the origin of these lesions.We discuss the case of a 67-year-old woman who presented with a six-year history of recurrent seizures. Magnetic resonance imaging revealed two similar heterogeneous intracranial masses in the ventral midbrain and left frontal white matter with indications of more aggressive behavior in the supratentorial tumor. The lesion was resected, and histopathological analysis showed tissue containing nodules of chondromyxoid material with a coarsely fibrillar matrix and focal alveolar pattern. Palisading cells were noted around the edges as well as dystrophic calcifications and osseous metaplasia, consistent with CAPNON. Interestingly, the patient had a previous history of multiple brain abscesses and a mycotic aneurysm. At her four-month follow-up visit, the patient remained seizure-free and there were no indications of residual tumor or recurrence.In contrast to previous reports, intracranial CAPNONs may manifest as multiple lesions and clinicians should include these tumors in the differential diagnosis of intra-axial calcified masses. The previous history of brain abscesses raises the suspicion of an abnormal proliferative process following an insult to the brain tissue as the underlying origin of these lesions.

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“…Calcified, fibro-osseous lesions known as calcifying pseudoneoplasms of the neuraxis, cerebral calculi, or brain stones are extremely rare and are usually seen at the cranial base, commonly adjacent to the dura mater or the arachnoid 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29. However, they can occur anywhere within the neuraxis 2,3,5.…”

Section: Discussionmentioning

confidence: 99%

“…The patients with intracranial type most commonly presented with seizure (31.6%) followed by headache (13.2%) and cerebellar sign (5.3%) 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23. Three patients (8.1%) were found incidentally, and seven cases (18.9%) were autopsy findings.…”

Section: Discussionmentioning

confidence: 99%

“…Infratentorial lesions were seen in 29.7% of them (not described in six cases). The patients with CVJ type most commonly presented with neck pain (75%), followed by headache (25%), facial pain (25%) and lower-extremity stiffness 3,5,20,24. Three of four cases were mainly located at the foramen magnum and another at the clivus to the upper cervical spine.…”

Section: Discussionmentioning

confidence: 99%

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Calcifying Pseudoneoplasms of the Skull Base Presenting with Cranial Neuropathies: Case Report and Literature Review

et al. 2012

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Objectives We report our institutional experience with calcifying pseudoneoplasms of the skull base that presented with cranial neuropathies. These lesions are also known as fibro-osseous lesions, cerebral calculi, or brain stones.Results One patient presented with facial numbness and retro-orbital pain secondary to compression of the maxillary branch of the trigeminal nerve at the anterior portion of the infratemporal fossa. The other patient presented with occipital headaches and hypoglossal nerve palsy. This patient was found to have a calcified lesion in the posterior fossa, which eroded the left occipital condyle.Conclusion Calcifying pseudoneoplasms are benign, slow-growing masses that are apparently cured by gross total resection. Even with incomplete tumor resection, the prognosis is considered to be favorable. We advocate a minimally invasive surgical resection of such tumors involving the cranial nerves.

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Fibro-osseous lesions involving the brain: MRI

Cited by 40 publications

References 0 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?

Multiple Calcifying Pseudoneoplasms of the Neuraxis

Calcifying Pseudoneoplasms of the Skull Base Presenting with Cranial Neuropathies: Case Report and Literature Review

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