Calcifying Pseudoneoplasm of the Cervicomedullary Junction: Case Report and a Literature Review.
BACKGROUND
Calcifying pseudoneoplasm of the neuroaxis (CAPNON) is a rare, slow-growing tumor of a fibro-osseous origin that may present anywhere in the neuroaxis. Although typically benign, symptoms of CAPNONs typically present secondary to compression and surrounding mass effect. Histologically, the tumor has the characteristics of a foreign body reaction with giant cells, ossification, and the formation of psammoma bodies. On imaging, they can easily be confused with malginant lesions such as chondrosarcoma or chondroblastoma or even more benign pathologies like meningioma.


METHODS
We present a case of a patient with an incidentally found calcifying pseudoneoplasm involving the cervicomedullary junction with further involvement of the vertebral artery and the hypoglossal nerve. We also review the literature on these tumors to date.


CONCLUSIONS
Calcifying pseudoneoplasm of the neuroaxis is a slow-growing, benign, noninfiltrative lesion whose pathogensis and natural history remains unclear. It can appear anywhere in the neuroaxis and does not have a prevelant location. Because of the indolent course and relative rarity of this tumor, there are no current guidelines on the immediate and long-term management of CAPNONs. This entity, although quite rare, should be considered in the differential for calcified lesions at the cervicomedullary junction. The consensus for treatment of CAPNONs when symptomatic is surgical resection.
Division of Neurosurgery, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA.
Mohammed
M
Alshareef
Division of Neurosurgery, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA.
Jan
J
Vargas
Department of Pathology, Medical University of South Carolina, Charleston, South Carolina, USA.
Cynthia T
CT
Welsh
Division of Neurosurgery, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA. Electronic address: kalhorn@gmail.com.
Stephen P
SP
Kalhorn
D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D002114:Calcinosis / Q000175:diagnosis / Q000601:surgery; D002533:Cerebral Angiography; D003399:Craniotomy; D003937:Diagnosis, Differential; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008526:Medulla Oblongata / Q000473:pathology*; D008577:Meningeal Neoplasms / Q000175:diagnosis; D008579:Meningioma / Q000175:diagnosis; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D035583:Rare Diseases; D013116:Spinal Cord / Q000473:pathology*
Brain tumor; CAPNON; Calcifying Pseudoneoplasm of the neuroaxis; Cervicomedullary junction; Spine tumor