Calcifying Pseudoneoplasm of the Neuraxis: A Case Illustrating Natural History over 17 Years of Radiologic Surveillance

Barber, Sean M.; Low, Jacob Chen Ming; Johns, Paul; Rich, Philip; MacDonald, Bridget; Jones, Timothy L.

doi:10.1016/j.wneu.2018.04.175

Cited by 23 publications

(35 citation statements)

References 49 publications

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“…The average age at presentation is 47 years and a slight male predilection is seen. 5 With regard to spinal CAPNONs, they are typically located in the epidural space (81.48%). 6 In contrast, intracranial CAPNONs are more commonly found intraaxially.…”

Section: Discussionmentioning

confidence: 99%

“…6 In contrast, intracranial CAPNONs are more commonly found intraaxially. [4][5][6] In this study, we reviewed a total of 24 cases located at the skull base and discovered a high incidence (45.8%) of cranial neuropathies associated with skull base CAPNONs. In our case report of a right CPA CAPNON, we present novel pathological findings of the CN involvement with NFP-positive entrapped nerve fibers/axons identified at the periphery of the lesion, correlating with clinical cranial neuropathy.…”

Section: Discussionmentioning

confidence: 99%

“…Second, CAPNONs are usually hypointense on T1WI and T2WI and perilesional edema is rare. 3,5 Additionally, the majority of cases of CAPNON demonstrate a peripheral enhancement pattern in contrast to psammomatous and metaplastic meningiomas. 5 Of note, our right CPA CAPNON is vividly enhancing with contrast, similar to a previous case reported by Alshareef and colleagues.…”

Section: Discussionmentioning

confidence: 99%

“…3 CAPNON can occur at any locations of the central nervous system, including the brain and spine, both intra-axial and extra-axial, with only a number of cases reported at the skull base. [3][4][5][6] In these cases, they are commonly mistaken as calcified meningiomas prior to surgical intervention. 3,4,[7][8][9][10] Here, we report two CAPNON lesions located at the skull base, and review skull base CAPNONs reported in the literature, with comparisons of CAPNONs and calcified meningiomas.…”

Section: Introductionmentioning

confidence: 99%

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Skull Base Calcifying Pseudoneoplasms of the Neuraxis: Two Case Reports and a Systematic Review of the Literature

Yang

Reddy

Ellenbogen

et al. 2019

Can. J. Neurol. Sci.

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ABSTRACT:Background:Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare tumefactive lesion. CAPNONs can mimic calcified meningiomas at the skull base.Methods:Here, we report two cases of CAPNON and present a systematic review of the literature on skull base CAPNONs, to compare CAPNONs with calcified meningiomas.Results:Case 1: A 57-year-old man presented with right-sided lower cranial neuropathies and gait ataxia. He underwent a subtotal resection of a right cerebellopontine angle lesion, with significant improvement of his gait ataxia. However, his cranial neuropathies persisted. Pathological examination of the lesion was diagnostic of CAPNON, with the entrapped nerve fibers identified at the periphery of the lesion, correlating with the patient’s cranial neuropathy. Case 2: A 70-year-old man presented with progressive headache, gait difficulty, and cognitive impairment. He underwent a frontotemporal craniotomy for a near-total resection of his right basal frontal CAPNON. He remained neurologically stable 7 years after the initial resection without evidence of disease recurrence. We analyzed 24 reported CAPNONs at the skull base in our systematic review of the literature. Cranial neuropathies were present in 11 (45.8%) patients. Outcomes regarding cranial neuropathies were documented in six patients: two had sacrifice of the nerve function with surgical approaches and four had persistent cranial neuropathies.Conclusion:While CAPNON can radiologically and grossly mimic calcified meningiomas, they are two distinctly different pathologies. CAPNONs located at the skull base are commonly associated with cranial neuropathies, which may be difficult to reverse despite surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Skull Base Calcifying Pseudoneoplasms of the Neuraxis: Two Case Reports and a Systematic Review of the Literature

Yang

Reddy

Ellenbogen

et al. 2019

Can. J. Neurol. Sci.

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“…In the majority of cases, growth is indolent, with a favourable prognosis following surgical excision. Extensive lesions may require a less radical resection with monitoring for local recurrence 13,14 …”

Section: Introductionmentioning

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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Giant calcified pseudoplasm of the nerve axis of the temporal lobe: a case report and review of the literature

Xiang

Liang

et al. 2021

Acta Neurol Belg

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Calcifying Pseudoneoplasm of the Neuraxis: A Case Illustrating Natural History over 17 Years of Radiologic Surveillance

Cited by 23 publications

References 49 publications

Skull Base Calcifying Pseudoneoplasms of the Neuraxis: Two Case Reports and a Systematic Review of the Literature

Skull Base Calcifying Pseudoneoplasms of the Neuraxis: Two Case Reports and a Systematic Review of the Literature

New insights into calcifying pseudoneoplasm of the neuraxis (CAPNON): a 20‐year radiological–pathological study of 37 cases

Giant calcified pseudoplasm of the nerve axis of the temporal lobe: a case report and review of the literature

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