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Intracranial fibroxanthoma in an infant: a case report
In Hee Chung1, Young Seok Lee, Na-Hye Myong
1Department of Radiology, Dankook University Hospital, Choongnam, Korea.
Insights
A rare infantile fibroxanthoma in a six-month-old mimicked a meningioma on imaging. This central nervous system tumor presented unique US, MRI, and PET/CT features.
Area of Science:
- Pediatric Neurology
- Neuro-oncology
- Diagnostic Imaging
Background:
- Primary central nervous system fibroxanthomas are exceptionally rare pediatric neoplasms.
- Differentiating these tumors from more common intracranial lesions is diagnostically challenging.
Observation:
- A six-month-old infant presented with a cranial dural mass.
- Ultrasound revealed a well-circumscribed, echogenic mass.
- CT showed isoattenuation, PET/CT indicated hypometabolism, and MRI demonstrated heterogeneous T2 hyperintensity with intense contrast enhancement.
Findings:
- The imaging features on ultrasound (US), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) closely resembled those of a meningioma.
- The tumor originated from the cranial dura mater.
Implications:
- This case highlights the importance of considering rare diagnoses in pediatric neuro-oncology.
- Accurate interpretation of multimodal imaging is crucial for differentiating infantile fibroxanthoma from meningioma.
- Early and precise diagnosis impacts timely and appropriate therapeutic strategies.
Abstract:
A primary fibroxanthoma of the central nervous system is very rare. We present a case of an infantile fibroxanthoma that arose from the cranial dura mater in a six-month-old girl with US, MRI and PET/CT features that mimicked a meningioma. The tumor appeared as a large, well-circumscribed echogenic mass in the right parieto-occipital area on US. The tumor was seen as isoattenuated to slightly hypoattenuated on pre-contrast CT scan and as hypometabolic on PET/CT. As seen on T2-weighted image, the mass was heterogeneously hyperintense to the gray matter. The mass was isointense on T1-weighted image and homogeneously strongly enhanced on contrast enhanced T1-weighted image.