R P Feldman1, A Marcovici, M Suarez, J T Goodrich. 1. Department of Neurological Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10461, USA.
Abstract
OBJECTIVE AND IMPORTANCE: Intracranial foreign body granulomas are rare. We describe a case of an intracranial foreign body granuloma found in a 17-year-old female patient 9 years after she underwent a craniotomy for a tumor of unknown type. Postoperative imaging of patients who have undergone neurosurgical procedures can often reveal enhancing masses, and foreign body granuloma should be included in the differential diagnosis. CLINICAL PRESENTATION: The patient presented with a history of developmental delay, panhypopituitarism, and chronic headache. Admission resulted from an acute increase in the severity of her headache. INTERVENTION: Imaging studies, including computed tomography and magnetic resonance imaging, demonstrated a 1.5 x 2 cm round, enhancing anterior interhemispheric mass, appearing to arise from the falx and causing mild mass effect. A nonenhancing cystic mass was also noted in the suprasellar region but was without mass effect. The patient underwent a craniotomy and removal of the anterior mass without complication, and her headache resolved. A pathological examination of the specimen confirmed the diagnosis of foreign body granuloma. CONCLUSION: Although rare, foreign body granuloma should be included in the differential diagnosis of previously operated intracranial masses. The importance of accurate historical information and guidelines that may assist in diagnosis are discussed.
OBJECTIVE AND IMPORTANCE: Intracranial foreign body granulomas are rare. We describe a case of an intracranial foreign body granuloma found in a 17-year-old female patient 9 years after she underwent a craniotomy for a tumor of unknown type. Postoperative imaging of patients who have undergone neurosurgical procedures can often reveal enhancing masses, and foreign body granuloma should be included in the differential diagnosis. CLINICAL PRESENTATION: The patient presented with a history of developmental delay, panhypopituitarism, and chronic headache. Admission resulted from an acute increase in the severity of her headache. INTERVENTION: Imaging studies, including computed tomography and magnetic resonance imaging, demonstrated a 1.5 x 2 cm round, enhancing anterior interhemispheric mass, appearing to arise from the falx and causing mild mass effect. A nonenhancing cystic mass was also noted in the suprasellar region but was without mass effect. The patient underwent a craniotomy and removal of the anterior mass without complication, and her headache resolved. A pathological examination of the specimen confirmed the diagnosis of foreign body granuloma. CONCLUSION: Although rare, foreign body granuloma should be included in the differential diagnosis of previously operated intracranial masses. The importance of accurate historical information and guidelines that may assist in diagnosis are discussed.