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Published on: September 25, 2019
Vanishing brain space-occupying lesion in a child: illustrative case
Abiodun Idowu Okunlola1,2, Oyeronke Sola Komolafe3, Hakeem Kayode Alade3
1Department of Surgery, Afe Babalola University, Ado-Ekiti.
Background:
Vanishing brain space-occupying lesions are rare clinical entities characterized by spontaneous regression of intracranial lesions before definitive diagnosis. They may mimic neoplastic or infective conditions, creating diagnostic uncertainty.
Observations:
A 14-year-old boy presented with recurrent complex partial seizures associated with postictal sleep. MRI demonstrated a left parietal intra-axial ring-enhancing lesion with surrounding vasogenic edema. The patient was started on a regimen of oral carbamazepine 200 mg twice daily, and he was scheduled for surgical excision, but his family declined because of financial constraints. Thirteen months later, repeat imaging revealed complete spontaneous resolution of the lesion and edema without medical or surgical intervention.
Lessons:
This case highlights the importance of careful clinical and radiological evaluation in children presenting with solitary ring-enhancing lesions. Some lesions may resolve spontaneously, particularly infective or inflammatory lesions, and unnecessary surgery may therefore be avoided. https://thejns.org/doi/10.3171/CASE26532.
Insights
Vanishing brain lesions, rare in children, can spontaneously resolve. This case shows a ring-enhancing lesion disappearing without intervention, avoiding unnecessary surgery.
Area of Science:
- Pediatric Neurology
- Neuroradiology
- Oncology
Background:
- Vanishing brain space-occupying lesions are rare and present diagnostic challenges.
- These lesions can mimic neoplastic or infectious conditions, causing uncertainty.
Purpose of the Study:
- To report a case of a vanishing brain lesion in a pediatric patient.
- To emphasize the importance of conservative management for certain intracranial lesions.
Main Methods:
- A 14-year-old boy with seizures presented with a ring-enhancing brain lesion.
- The patient was managed conservatively due to financial constraints, with follow-up MRI.
Main Results:
- The intracranial lesion and surrounding edema completely resolved spontaneously over 13 months.
- No medical or surgical intervention was required for the resolution.
Conclusions:
- Solitary ring-enhancing lesions in children may resolve spontaneously.
- Careful clinical and radiological evaluation can help avoid unnecessary surgical intervention for presumed brain tumors.
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