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[Intracerebral xanthogranuloma with specific MRI features: a case report]
Junzo Nakao1, Shingo Takano, Shinya Watanabe
1Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba-city, Ibaraki, Japan.
No Shinkei Geka. Neurological Surgery
|November 1, 2011
Summary
A rare brain xanthogranuloma was diagnosed in a patient with a history of acute myelocytic leukemia and stem cell transplant. This case highlights the importance of considering unusual diagnoses in immunocompromised patients with brain lesions.
Area of Science:
- Neurology
- Oncology
- Radiology
Background:
- A 47-year-old male with a history of acute myelocytic leukemia and peripheral blood stem cell transplantation presented with progressive right leg motor weakness.
- Magnetic resonance imaging (MRI) revealed a left frontal lobe mass, initially suspected to be a brain abscess.
Observation:
- The mass exhibited specific MRI characteristics: low intensity on T1-weighted and diffusion-weighted images, high intensity with linear shadows on T2-weighted images, and incomplete ring-like Gd-enhancement.
- Neurological symptoms worsened, and the mass size increased despite antibacterial treatment.
- MR spectroscopy showed elevated choline and lactate peaks, suggesting a differential diagnosis of glioma or demyelinating disease.
Findings:
- Intraoperative findings described the mass as light yellow and vascular.
- Pathological diagnosis confirmed the lesion as a brain xanthogranuloma.
- Postoperative recovery was uneventful, with residual mass and enhancement reduction observed on follow-up MRI.
Implications:
- This case underscores the importance of considering xanthogranuloma in the differential diagnosis of brain lesions, particularly in immunocompromised patients.
- The specific MRI findings and clinical presentation provide valuable insights for diagnosing similar rare intracranial tumors.
- Successful surgical management and postoperative outcomes highlight the feasibility of treating brain xanthogranulomas.
