Calcifying pseudoneoplasm of the neuraxis in direct continuity with a low‐grade glioma: A case report and review of the literature. Issue 5 (7th April 2017)

• Record Type: Journal Article
• Authors: Higa, Nayuta; Yokoo, Hideaki; Hirano, Hirofumi; Yonezawa, Hajime; Oyoshi, Tatsuki; Goto, Yuko; Arita, Kazunori
• Is Part Of: Neuropathology. Volume 37:Issue 5(2017:Oct.)
• Page Start: 446
• Page End: 451
• Publication Date: 2017-04-07
• Subjects: GFAP -- low‐grade glioma -- neoplasm -- nestin; Nervous system -- Diseases -- Periodicals; Nervous system -- Pathophysiology -- Periodicals; 616.8047
• DOI: 10.1111/neup.12384
• Languages: English
• ISSNs: 0919-6544

Abstract

Abstract : 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.