Regrowth and progression of multiple calcifying pseudoneoplasms of the neuraxis: Case report

Watanabe, Akira; Nakanishi, Kinya; Kataoka, Keisuke; Wakasa, T.; Ohta, Yoshihiro

doi:10.4103/sni.sni_181_18

Cited by 13 publications

(13 citation statements)

References 11 publications

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“…Reports of dual pathology or ‘collision’ lesions include pericallosal lipoma, meningioangiomatosis, dysembryoplastic neuroepithelial tumour, ependymoma, low‐grade glioma, and meningioma 10,34‐39 . Rarely, multiple CAPNON lesions have been identified in the same patient with dissemination in space and/or time 39‐42 …”

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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“…9 CAPNON is most often solitary, except for 4 reported cases with multiple intracranial lesions. [10][11][12][13] Here, we present a case of CAPNON at the right posterior skull base in a 44-year-old woman. To our knowledge, only 27 cases of CAPNON at the skull base have been reported between 1989 and 2020 (Table 1), 2,[4][5][6]8,[14][15][16][17][18][19][20][21][22][23][24][25][26][27] with ages ranging from 19 to 70 years (median age: 50 years) and a male predominance (malefemale ratio, 1.7:1).…”

Section: Discussionmentioning

confidence: 94%

“…6,8,28 In addition, it has been reported that CAPNON does not display mitoses. 9,13 In most cases, the palisading epithelioid cells surrounding the matrix are positive for vimentin, with variable intensity, and EMA may be positive in a few cells. Glial fibrillary acidic protein and S100 are negative in CAPNON.…”

Section: Table 1 (Continued)mentioning

confidence: 99%

Calcifying Pseudoneoplasm of the Neuraxis Involving the Posterior Skull Base: A Case Report and Literature Review

Yan¹,

Menon²,

Heim-Hall³

et al. 2021

Int J Surg Pathol

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Calcifying pseudoneoplasm of the neuraxis is an uncommon, nonneoplastic fibro-osseous lesion of the central nervous system. At the time of this report, at least 150 cases have been reported in the literature. Because of the rarity of this lesion, it is often diagnostically challenging for radiologists and pathologists alike. In this article, we present a case of a 44-year-old woman with a 5.8-cm intracranial/skull base calcifying pseudoneoplasm of the neuraxis that was concerning for osteosarcoma on initial frozen section. Permanent sections revealed bone and fibrous stroma, calcifications, and nests of histiocytes with granuloma formation. Scattered, focally dense inflammatory foci and spindled cells outlining abundant large nodules of chondromyxoid matrix were also present. In this case report, we also reviewed recent literature for clinical presentations, radiologic findings, and histologic differential diagnoses. Familiarity with this lesion is important to avoid misdiagnosis leading to unnecessary and potentially harmful treatment.

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“…On CT, CAPNON presents as well-defined solid lesions that are completely calcified or show calcification at the periphery. 7 On MRI, CAPNON typically shows hypointense signals on T1-and T2-weighted sequences, with minimal or no contrast enhancement, and edema is rarely observed. 10 However, in our patient, the lesion in the right frontal lobe appeared hypointense on T1-weighted images, and hypointense on T2-weighted FLAIR images with a slightly isointense signal in the rim, together with the adjacent hyperintense area indicative of edema.…”

Section: Discussionmentioning

confidence: 99%

Calcifying pseudoneoplasms of the neuraxis (CAPNON). A case report

Wang

Zhang

et al. 2021

Neuropathology

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Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare, slow-growing, benign lesions occurring throughout the neuroaxis that are frequently misdiagnosed and overlooked by clinicians. Here, we report a case of a 56-year-old woman who presented with a history of recurrent headache for the previous six years. Magnetic resonance imaging (MRI) revealed a 2.3-cm-sized solid mass in the right frontal lobe that was surrounded by marked edematous areas. The lesion demonstrated dense calcification and avid enhancement. The lesion was initially diagnosed as oligodendroglioma, and then found to be CAPNON based on histopathology of a surgically resected tissue. Genetic analysis revealed a nonsense mutation in the CUL4B gene. The patient's condition appeared to reflect a reactive, rather than neoplastic, process. Clinicians should be prepared to detect such pseudotumors histopathologically in order to avoid unnecessary differential tests of neoplastic or infectious diseases, as well as potentially harmful therapies.

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Regrowth and progression of multiple calcifying pseudoneoplasms of the neuraxis: Case report

Cited by 13 publications

References 11 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

Calcifying Pseudoneoplasm of the Neuraxis Involving the Posterior Skull Base: A Case Report and Literature Review

Calcifying pseudoneoplasms of the neuraxis (CAPNON). A case report

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