title: Supratentorial calcified pseudotumour: experience of a single institution and review of the literature.
abstract: BACKGROUND
  Calcified pseudotumours (CPTs) are rarely found in the central nervous system (CNS). Information on supratentorial CPT is limited. We add our experience treating three supratentorial CPTs. Clinical presentation, pathological findings and clinical course are discussed, and a literature review is provided.
  
  
  METHODS
  Between September 2011 and December 2012, three patients (age range 33-60 years) were diagnosed with symptomatic supratentorial CPTs, for which they underwent resection. Their clinical, radiological, and surgical data were retrospectively retrieved from their medical records and reported.
  
  
  RESULTS
  Symptoms at presentation included headache (n = 1), blurred vision (n = 1), and cognitive decline (n = 1). One tumour was in the left frontal lobe very close to the convexity surface, and the other two were in the midline adjacent to the corpus callosum. Radiological features included a calcified mass on computerised tomography (n = 3), a hypointense (n = 2) or hyperintense (n = 1) signal on T2 and a rim of enhancement with some non-homogenous lesional enhancement on T1-gadolinium (Gd) sequences on magnetic resonance imaging (n = 2). Two patients underwent gross total resection and had an uneventful postoperative course. The third underwent partial removal due to the tumour's adherence to adjacent vascular structures and suffered postoperative complications. On pathology, all lesions had low cellularity fibrovascular tissue mixed with lobules of a haematoxylinophilic, chondromyxoid-like matrix surrounded at its periphery by a variable layer of palisading spindle, epithelioid or multinucleated giant cells. All three CPTs had focal inflammatory infiltrates and variable degrees of metaplastic calcification and ossification.
  
  
  CONCLUSIONS
  Surgical removal is recommended for benign intracranial CPTs that are symptomatic, are associated with brain oedema, or show tumour growth. Stable and asymptomatic CPTs can be followed.
authors.affiliation: Department of Neurosurgery, Tel-Aviv Medical Centre, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Shimony
authors.forename: Asaf
authors.initials: A
authors.lastname: Aizic
authors.forename: Emanuela
authors.initials: E
authors.lastname: Cagnano
authors.forename: Nevo
authors.initials: N
authors.lastname: Margalit
authors.forename: Zvi
authors.initials: Z
authors.lastname: Ram
authors.forename: Shlomi
authors.initials: S
authors.lastname: Constantini
authors.forename: Jonathan
authors.initials: J
authors.lastname: Roth
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000473:pathology* / Q000601:surgery; D003337:Corpus Callosum / Q000473:pathology / Q000601:surgery; D005625:Frontal Lobe / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D015173:Supratentorial Neoplasms / Q000473:pathology* / Q000601:surgery