Psammomatous Cavernous Malformation Presenting as Drug-Resistant Epilepsy: Case Illustration and Review of Literature.
BACKGROUND
Psammoma bodies (PBs) are whorled, laminated hyaline spherules containing calcium deposits. Intracranially, the presence of PBs is associated with variants of meningioma and pituitary lesions, as well as aging choroid plexus. Limited information exists on their presence in vascular malformation.


RESULTS
In this report, we describe a case of an adolescent male with drug-resistant epilepsy that was surgically managed at our regional epilepsy center. The epileptogenic focus was determined to be emanating from an indolent right insular lesion. Histopathologic evaluation showed the abundance of intravascular and perivascular PBs. Immunohistochemical evaluation confirmed the vascular origin using vascular markers. The unusual presence of PBs in a vascular lesion was unanticipated.


CONCLUSIONS
Based on our case, we present the clinicoradiologic characteristics, supplemented with intraoperative findings, for this unusual lesion. In addition, because of the unusual presence of PBs in vascular lesions, we provide the findings of a systematic literature review to show the association of PBs with intracranial vascular lesions.
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Kanika
K
Sharma
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Piyush
P
Kalakoti
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
John E
JE
Shaughnessy
Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Nestor
N
De La Cruz
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Rimal H
RH
Dossani
Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Peimin
P
Zhu
Department of Neuro-radiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Eduardo
E
Gonzalez-Toledo
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Christina
C
Ledbetter
Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
James B
JB
Pinskton
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Anil
A
Nanda
Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Rosario Maria
RM
Riel-Romero
Department of Neurology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Alireza
A
Minagar
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
Christina
C
Notarianni
Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA. Electronic address: hsun2@lsuhsc.edu.
Hai
H
Sun
D000293:Adolescent; D003937:Diagnosis, Differential; D000069279:Drug Resistant Epilepsy / Q000209:etiology* / Q000473:pathology*; D020786:Hemangioma, Cavernous, Central Nervous System / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008297:Male; D061205:Vascular Calcification / Q000150:complications* / Q000473:pathology*
Cavernoma; Drug-resistant epilepsy; Electrocorticography; Psammoma; Vascular malformation