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Review
. 2014 Dec 5:2014:bcr2014206855.
doi: 10.1136/bcr-2014-206855.

Occipital calcified pseudoneoplasms of the neuraxis (CAPNON): understanding a rare pathology

Kirill Lyapichev  1 , Amade Bregy  2 , Ashish H Shah  2 , Kinjal Shah  1 , Mehul B Desai  3 , Carol Petito  1 , Ricardo J Komotar  2
Affiliations
Review

Occipital calcified pseudoneoplasms of the neuraxis (CAPNON): understanding a rare pathology

Kirill Lyapichev et al. BMJ Case Rep. .

Abstract

Calcifying pseudoneoplasms of the neuraxis (CAPNON) are rare and typically benign lesions that can occur anywhere within the central nervous system. Aetiology of this lesion is unclear and surgical removal is usually curative. We present a 24-year-old male patient with a history of occipital migraines who was admitted after sudden onset seizure and loss of vision. CT and MRI demonstrated a small calcifying lesion in the right temporo-occipital lobe. The patient underwent gross total resection of the tumour mass and pathological analysis revealed a CAPNON. The preoperative diagnosis of CAPNON remains difficult due to unspecific radiological findings, yet a clear understanding of characteristic pathological findings and prognosis of CAPNON remains paramount.

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Figures

Figure 1
Figure 1
(A) Preoperative axial CT scan showing space-occupying lesion, located in the right temporo-occipital lobe, without significant mass effect and marginal calcification. (B) Axial T1-weighted non-contrast MRI demonstrating heterogeneous lesion with increased and decreased T1 signal, with absent enhancement postcontrast (C). (D) Axial fluid-attenuated inversion recovery MRI showing peripheral increased signal and central decreased signal in the lesion.
Figure 2
Figure 2
A well-circumscribed, extensively calcified lesion admixed with reactive astrocytosis. Multiple psammoma bodies are found on H&E staining (A). Immunohistochemistry is positive for glial fibrillar acidic protein (B) and negative for epithelial membrane antigen (not shown).
Figure 3
Figure 3
Postoperative axial T1-weighted MRI showing status—postresection of temporo-occipital brain tumour by occipital craniotomy. Surgical cavity is containing blood but no residual tumour. No midline shift or mass effect present.
See this image and copyright information in PMC

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