Calcifying pseudoneoplasm of the neuraxis

Pithon, Rafaela Fonseca Albuquerque; Bahia, Paulo Roberto Valle; Marcondes, Jorge; Canêdo, Nathalie Henriques Silva; Marchiori, Edson

doi:10.1590/0100-3984.2017.0171

Cited by 8 publications

(8 citation statements)

References 10 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On CT, the characteristic finding is of a dense calcified mass, just as seen in our patient. However, the diagnostic hypothesis cannot be firmed solely on CT grounds since many intracranial lesions may present as calcified masses [20][21][22]. On MR, a characteristic pattern of a diffuse hypointense mass is observed in all sequences, especially on susceptibility-weighted ones, due to the presence of the calcification.…”

Section: Discussionmentioning

confidence: 99%

Intracerebral Calcifying Pseudoneoplasm of the Neuroaxis (CAPNON) Presenting with an Atypical Immunohistochemical Profile: Case Report and Review of the Literature

Alencar¹,

Coelho²,

Ferreira-Filho³

et al. 2020

SCR

View full text Add to dashboard Cite

Background: Calcifying pseudoneoplasm of the neuroaxis (CAPNON) is a very rare benign lesion that can be located anywhere in the nervous system, with only 59 intracranial cases described. The general lack of knowledge about this lesion hinders its preoperative diagnosis. Despite the consistent image findings, the final diagnosis is only established based on anatomopathological and immunohistochemical studies. The lesion is more commonly positive for epithelial membrane antigen (EMA) and vimentin, and negative for glial fibrillary acidic protein (GFAP) and S-100, suggesting a leptomeningeal origin. The opposite, however, may also occur, although very rarely (just two cases positive for GFAP and negative for EMA and vimentin reported this far). The treatment consists of total resection of the lesion, which yields a good prognosis. Case Presentation: We report the case of a 23-year-old female who presented with disperceptive focal seizures, sometimes evolving to bilateral tonic-clonic seizures, starting at age 9. She had a nodular calcified lesion in the left precuneus and inferior parietal lobe. The lesion was completely resected, and the immunohistochemical study revealed positivity for EMA, vimentin, GFAP, and S-100. No case hitherto published was positive for all four markers. This atypical immunohistochemical profile of the CAPNON may suggest a dual origin of this lesion, both parenchymal and leptomeningeal. Conclusion: The general lack of knowledge of CAPNON makes this lesion underdiagnosed. Therefore, in the face of a calcified lesion in the nervous system, one should consider the possibility of a CAPNON among the differential diagnoses. The immunohistochemistry is undoubtedly an important tool, but the anatomopathological study, associated with image findings, remain the gold standard for the diagnosis of CAPNON.

show abstract

Section: Discussionmentioning

confidence: 99%

Intracerebral Calcifying Pseudoneoplasm of the Neuroaxis (CAPNON) Presenting with an Atypical Immunohistochemical Profile: Case Report and Review of the Literature

Alencar¹,

Coelho²,

Ferreira-Filho³

et al. 2020

SCR

View full text Add to dashboard Cite

show abstract

“…6,7 While the etiology of CAPNON remains unclear, most evidence argues for a reactive, rather than neoplastic, process. 3,4…”

Section: Introductionmentioning

confidence: 99%

“…The lesions, which are typically extra‐axial, can appear infra‐ and supratentorially, and computed tomography (CT) usually reveals a well‐demarcated, calcified intracranial solid lesion. On magnetic resonance imaging (MRI), the lesions appear uniformly hypointense on T1‐ and T2‐weighted images, usually without perilesional edema 4 . CAPNON histology includes the following four characteristics: (1) amorphous mucochondral matrix with a nodular pattern; (2) palisadingly arranged mononuclear histiocytes or epithelioid cells; (3) variable amounts of fibrous stroma; osseousstructures containing birefringent lamellar bone, calcium deposits, and (4) psammoma bodies; and a foreign‐bodygranuloma 3,5 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Wang

Zhang

et al. 2021

Neuropathology

View full text Add to dashboard Cite

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.

show abstract

“…There are numerous etiologies associated with thalamic lesions, and it is essential to investigate the clinical and biochemical history of the patient before requesting an imaging examination. Recent studies in the radiology literature of Brazil have highlighted the importance of imaging examinations for improving the diagnosis of neurological diseases (1)(2)(3)(4)(5) .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of neuroimaging findings in thalamic lesions: what can we think?

Ribeiro

Marchiori

2021

Radiol Bras

Self Cite

View full text Add to dashboard Cite

The diseases that affect the thalamus are heterogeneous in their etiologies, including infectious, inflammatory, vascular, toxic-metabolic, and neoplastic causes. It is often difficult to make the clinical differentiation between different entities. Within this context, computed tomography and magnetic resonance imaging have come to be of fundamental importance for defining the etiology and planning the treatment. In this pictorial essay, we will illustrate the main causes of diseases affecting the thalamus, discussing the possible differential diagnoses, as well as the most relevant imaging aspects.

show abstract

Calcifying pseudoneoplasm of the neuraxis

Cited by 8 publications

References 10 publications

Intracerebral Calcifying Pseudoneoplasm of the Neuroaxis (CAPNON) Presenting with an Atypical Immunohistochemical Profile: Case Report and Review of the Literature

Intracerebral Calcifying Pseudoneoplasm of the Neuroaxis (CAPNON) Presenting with an Atypical Immunohistochemical Profile: Case Report and Review of the Literature

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

Evaluation of neuroimaging findings in thalamic lesions: what can we think?

Contact Info

Product

Resources

About