Intracranial Papillary Endothelial Hyperplasia: Occurrence of a Case After Surgery and Radiosurgery

Abstract

Papillary endothelial hyperplasia (PEH) is considered a form of endothelial proliferation rather than a true neoplasm and is usually located in the skin or subcutis. We report a case of intracranial PEH that occurred after surgery for glioma and subsequent radiosurgery. CT and MR revealed an enhancing extra-axial mass located left posterolateral to the brainstem. Intracranial PEH is rare; to our knowledge, development of an intracranial PEH after surgery and radiosurgery has not been previously reported.

Masson´s Tumor in the Maxillary Sinus

“…The growth is supposed to be caused by disturbed local hemodynamic that induce progression of thrombus formation and subsequent development and growth of IPEH [5]. Despite its benign histology, IPEH may demonstrate aggressive behaviour including progressive enlargement and recurrence after incomplete resection [5,6,12].…”

Thirteen-year follow-up of parasellar intravascular papillary endothelial hyperplasia successfully treated by surgical excision: case report

“…4D-F [1][2][3][4]12,14,[16][17][18][19] Among these many names for this condition, IPEH is increasingly used, as it directly describes the disease pathology. 3,[5][6][7][8][9][10]13,15 IPEH was originally considered as a neoplasm, but it is currently regarded as an unusual nonneoplastic, reactive endothelial proliferation associated with organizing thrombi. These masses can occur either within the normal intravascular space (primary or pure type), within a preexisting vascular malformation (secondary or mixed type), or less commonly, in extravascular hematomas (undetermined or extravascular type).…”

“…3,6,11,14,19 IPEH can occur in various parts of the body, including a number of internal organs (gastrointestinal tract, kidney, liver, lung, uterus, etc. ), head and neck structures (nasal cavity, pharynx, and larynx), and most commonly, in skin and subcutaneous tissue of the upper extremities.…”

“…To date, only 22 cases of intracranial IPEH have been reported. [1][2][3][4][5][6][7][8][9][12][13][14][15][16][17][18][19] Because of its rarity, the natural history and treatment guidelines for intracranial IPEH have not been fully elucidated. Moreover, to our knowledge long-term follow-up data after surgical treatment of intracranial IPEH have not previously been published.…”

“…), head and neck structures (nasal cavity, pharynx, and larynx), and most commonly, in skin and subcutaneous tissue of the upper extremities. 3,6,14,19 While extracranial IPEH usually presents as a slow-growing painful benign nodule, 6,14 IPEH involving intracranial structures sometimes leads to serious local compressive symptoms, such as cranial nerve palsy, or a potentially fatal increase in intracranial pressure. To date, only 22 cases of intracranial IPEH have been reported.…”