Corpora amylacea mimicking low-grade glioma and manifesting as a seizure: Case report

Abstract

Background: Corpora amylacea (CA) are accumulations of polyglucosan bodies typically found in astrocytic foot processes, and rarely, can mimic neoplasm. CA accumulation has also been associated with seizure disorders. We report the first case of a histologically confirmed intracranial, intraparenchymal CA lesion mimicking a low-grade glioma and manifesting as a seizure.

Case description: A 43-year-old man presented after a general tonic-clonic (GTC) seizure. Brain magnetic resonance imaging (MRI) revealed a small lesion in the right mesial temporal lobe with radiologic features of a low-grade glioma. The patient underwent a right pteronial craniotomy for resection of the lesion. Histology demonstrated abundant polyglucosan bodies without neoplastic features. The patient tolerated the procedure well, was free from seizures without antiepileptic drugs at 2-week follow-up, and is undergoing serial surveillance.

Conclusion: The clinical manifestation of CA as a seizure in the context of an identified brain mass is extraordinarily rare. Nevertheless, CA should be considered in the differential diagnosis for patients with seizures and a radiologically identifiable low-grade lesion. Symptomatic CA lesions Mimicking a low-grade glioma should be surgically pursued with a goal of safe, maximal resection to confirm the diagnosis and to provide the patient with prognosis, which can significantly impact patient quality of life.

Keywords: Case reports; corpora amylacea; glioma; pathology; seizures.

Figure 1

Schematic diagram of T2-weighted axial (a) and coronal (b) images revealing a nonenhancing hyperintense lesion in the right mesial temporal lobe. Axial (c) and coronal FLAIR sequences (d) showing a hyperintense lesion in the white matter of the right mesial temporal lobe

Figure 2

Schematic diagram of a 20× magnification of H and E stained specimen revealing polyglucosan bodies (a) and 20× magnification of CA stained pink with periodic-acid Schiff staining (b)