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

Kanika Sharma, Piyush Kalakoti, John E. Shaughnessy, Nestor De La Cruz, Rimal H. Dossani, Peimin Zhu, Eduardo Gonzalez-Toledo, Christina Ledbetter, James B. Pinskton, Anil Nanda, Rosario Maria Riel-Romero, Christina Notarianni, Hai Sun

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)120-126
Number of pages7
JournalWorld Neurosurgery
Volume93
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Surgery

Keywords

  • Cavernoma
  • Drug-resistant epilepsy
  • Electrocorticography
  • Psammoma
  • Vascular malformation

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