Download PDF
CC BY-NC-ND 4.0 · J Neurol Surg Rep 2018; 79(03): e75-e78
DOI: 10.1055/s-0038-1673392
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Anterior Cranial Fossa Calcifying Pseudoneoplasm of the Neuroaxis—Diagnosis Using a Transblepharoplasty Approach

Timothy C. Blood
1   Department of Otolaryngology–Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, United States
,
Fausto J. Rodriguez
2   Department of Pathology, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Norris Nolan
3   Department of Pathology, Johns Hopkins University School of Medicine, Suburban Hospital, Bethesda, Maryland, United States
,
Murugappan Ramanathan Jr.
4   Department of Neurosurgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
,
Shaun C. Desai
5   Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
› Author Affiliations
Further Information

Publication History

13 February 2018

29 June 2018

Publication Date:
27 September 2018 (online)

Also available at
   Permissions and Reprints

Abstract

Calcifying pseudoneoplasms of the neuroaxis (CAPNON) are rare, benign tumors of unknown histogenesis. CAPNON generally are found intracranially or within the spinal column in symptomatic patients. We present the case of an asymptomatic patient with an incidentally discovered right anterior cranial fossa mass with extension through the posterior and anterior table of the right frontal sinus and right superior orbital roof. Open biopsy was performed via a transblepharoplasty incision with pathological diagnosis of CAPNON. The biopsy approach was well hidden and resulted in minimal to no postoperative scarring and little postoperative pain. We present the first documented case of CAPNON involving the frontal sinus via the anterior cranial base. Given our experience, in a patient with a mass involving the frontal sinus and superior orbital rim, the transblepharoplasty approach provides excellent exposure and access for pathological diagnosis. Further, we recommend that CAPNON remain on the differential for aggressive appearing calcified masses of the anterior cranial fossa.

Keywords

CAPNON - calcifying pseudoneoplasms of the neuroaxis - transblepharoplasty - frontal sinus - anterior skull base - minimally invasive
 

  • References

  • 1 García Duque S, Medina Lopez D, Ortiz de Méndivil A, Diamantopoulos Fernández J. Calcifying pseudoneoplasms of the neuroaxis: report on four cases and review of the literature. Clin Neurol Neurosurg 2016; 143: 116-120
    CrossrefPubMedGoogle Scholar
  • 2 Rhodes RH, Davis RL. An unusual fibro-osseous component in intracranial lesions. Hum Pathol 1978; 9 (03) 309-319
    CrossrefPubMedGoogle Scholar
  • 3 Mohapatra I, Manish R, Mahadevan A, Prasad C, Sampath S, Shankar SK. Calcifying pseudoneoplasm (fibro osseous lesion) of neuroaxis (CAPNON) – a case report. Clin Neuropathol 2010; 29 (04) 223-226
    CrossrefPubMedGoogle Scholar
  • 4 Bertoni F, Unni KK, Dahlin DC, Beabout JW, Onofrio BM. Calcifying pseudoneoplasms of the neural axis. J Neurosurg 1990; 72 (01) 42-48
    CrossrefPubMedGoogle Scholar
  • 5 Fletcher AM, Greenlee JJ, Chang KE, Smoker WR, Kirby PA, O'Brien EK. Endoscopic resection of calcifying pseudoneoplasm of the neuroaxis (CAPNON) of the anterior skull base with sinonasal extension. J Clin Neurosci 2012; 19 (07) 1048-1049
    CrossrefPubMedGoogle Scholar
  • 6 Knipe TA, Gandhi PD, Fleming JC, Chandra RK. Transblepharoplasty approach to sequestered disease of the lateral frontal sinus with ophthalmologic manifestations. Am J Rhinol 2007; 21 (01) 100-104
    CrossrefPubMedGoogle Scholar
  • 7 Chu EA, Quinones-Hinojosa A, Boahene KD. Trans-blepharoplasty orbitofrontal craniotomy for repair of lateral and posterior frontal sinus cerebrospinal fluid leak. Otolaryngol Head Neck Surg 2010; 142 (06) 906-908
    CrossrefPubMedGoogle Scholar
  • 8 Raza SM, Boahene KD, Quinones-Hinojosa A. The transpalpebral incision: its use in keyhole approaches to cranial base brain tumors. Expert Rev Neurother 2010; 10 (11) 1629-1632
    PubMedGoogle Scholar
  • 9 Owusu Boahene KD, Lim M, Chu E, Quinones-Hinojosa A. Transpalpebral orbitofrontal craniotomy: a minimally invasive approach to anterior cranial vault lesions. Skull Base 2010; 20 (04) 237-244
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Andaluz N, Romano A, Reddy LV, Zuccarello M. Eyelid approach to the anterior cranial base. J Neurosurg 2008; 109 (02) 341-346
    CrossrefPubMedGoogle Scholar