Psammomatous Cavernous Malformation Presenting as Drug Resistant Epilepsy: Case Illustration and Review of Literature

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. In...

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Bibliographic Details
Published in:World neurosurgery 2016-09, Vol.93, p.120-126
Main Authors: Sharma, Kanika, MD, Kalakoti, Piyush, MD, Shaughnessy, John E., BS, De La Cruz, Nestor, MD, Dossani, Rimal H., MD, Zhu, Peimin, MD, Gonzalez-Toledo, Eduardo, MD, PhD, Ledbetter, Christina, PhD, Pinskton, James B., PhD, Nanda, Anil, MD, MPH, Riel-Romero, Rosario Maria, MD, Minagar, Alireza, MD, Notarianni, Christina, MD, Sun, Hai, MD, PhD
Format: Article
Language:English
Subjects:
Adolescent
Cavernoma
Diagnosis, Differential
Drug Resistant Epilepsy - etiology
Drug Resistant Epilepsy - pathology
Drug-resistant epilepsy
Electrocorticography
Hemangioma, Cavernous, Central Nervous System - complications
Hemangioma, Cavernous, Central Nervous System - pathology
Humans
Male
Neurosurgery
Psammoma
Vascular Calcification - complications
Vascular Calcification - pathology
Vascular malformation
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Summary: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. 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. 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.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2016.05.093