2008, Number 1
Arch Neurocien 2008; 13 (1)
Ibarra TA, Solís MG, García BC, Vicuña GRM, Pasquel GP, Aguilar CJR
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ABSTRACTObjective and importance: the Castleman’s disease is a benign linphoploriferative disorder of unknown etiology mostly involving the mediastinum and the first report was by Benjamin Castleman in 1954; intracranial involvement in Castleman’s disease is very unusual. We report clinical, radiological, and pathological features of intracranial involvement in a case of Castleman’s disease. Clinical presentation. a female patient of 39 years old, with history of splenectmy 75 g for a inflamatory pseudotumor in 1995, spondiloartropaty in the 2000, linfadenitis in the 2001 and a molar pregnant. She began with asthenia, adinamia, low feeding, holocranial headache 7/10, nauseas and vomiting, improvement with anti-inflamatory no esteroids, partial seizures secondary generalized, left hemi paresia, hemianestesia and fever, with periods of aggravate and improvement in three years period; in the neurological examination with papiledema and paresis of the left thoracic limb. Intervention: in the computed tomography (CT) and magnetic resonance imaging (MRI), with a neoplasic lesion extra-axial in plaque and wide base of dural attachment, right fronto-parietal and homogeneous enhancement, mimicking a meningioma; in laboratory estudies with platelets in 1 132 000 x mm3. By surgery a resection of the tumor with wide dural attachment, solid, yellow - brown color and pale core; studies pathologic was a lesion meningeal inflammatory pseudotumor compatible with intracranial Castleman’s disease. Evolution of the patient had neurological improvement but with a intermitent febril syndrome, low feeding and pleural effusion, monitoring by hematology and neurology last control May 15, 2007 where she presents purple injuries in both arms is made biopsy that reports vasculitis is left with minimum doses of steroids neurologically stays free of focal motor seizures refers parestesias brachial lefts that can correspond to somatosensory seizures leaves with oxcarbazepine 900 mg/day. Conclusion: we presented a patient with intracranial Castleman’s disease with symptoms of elevated intracranial pressure and neurologic focalization, with antecedent of linfoploriferative systemic disease; by neuroimagen in the CT and MRI we find mimicking with a meningioma in plaque. The patient had improvement possurgical resection of the frontoparietal lesion.