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Calcifying pseudoneoplasm of the neuraxis in direct continuity with a low‐grade glioma: A case report and review of the literature
Author(s) -
Higa Nayuta,
Yokoo Hideaki,
Hirano Hirofumi,
Yonezawa Hajime,
Oyoshi Tatsuki,
Goto Yuko,
Arita Kazunori
Publication year - 2017
Publication title -
neuropathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 61
eISSN - 1440-1789
pISSN - 0919-6544
DOI - 10.1111/neup.12384
Subject(s) - pathology , medicine , lesion , magnetic resonance imaging , neoplasm , gadolinium , radiology , anatomy , chemistry , organic chemistry
Calcifying pseudoneoplasms of the neuraxis (CAPNON) are presumed to be a non‐neoplastic reactive pathology, based on the frequent finding of granulomatous inflammation. To our knowledge, there are few reports of CAPNON in association with a neoplasm. Here, we report the case of a 62‐year‐old man presenting with headache, which was caused by CAPNON in the left cingulate gyrus. CT scan revealed a calcified mass exhibiting gradual growth and increasing peritumoral edema. MRI showed an intra‐axial hypointense mass on T1‐ and T2‐weighted images. Development of a peri‐lesional hyperintense lesion on T2‐weighted images suggested local edema or tumoral invasion. Gadolinium‐enhanced T1‐weighted images revealed mild peripheral enhancement of the calcified nodule. L‐methyl‐ 11 C methionine‐positron emission tomography revealed the uptake of tracer in the calcified nodule. The calcified mass and its enveloping brain tissue were removed using a parietal craniotomy. The calcified tissue was surrounded by spindle‐shaped cells positive for GFAP and nestin. The MIB‐1 labeling index of spindle cells was around 10% (i.e. a hot spot). Fourteen months after surgery, gadolinium‐enhanced MRI evidenced growth of a tiny residual lesion. Therefore, this report illustrates a potential case of CAPNON arising from low‐grade glial neoplasm.