Intravascular Papillary Endothelial Hyperplasia of the Pineal Region: A Case Report and Review of the Literature. World Neurosurg 2020 Jan;133:308-313
Date
09/17/2019Pubmed ID
31525486DOI
10.1016/j.wneu.2019.09.022Scopus ID
2-s2.0-85074631872 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
BACKGROUND: Intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular lesion that is uncommon in the central nervous system. To our knowledge, there has been only one previous report of occurrence in the pineal region. We present a second case and a review of the literature.
CASE DESCRIPTION: A 28-year-old woman presented with 1 month of headaches and visual auras. Brain magnetic resonance imaging scan demonstrated a 2.6- × 1.8- × 1.3-cm nonenhancing T1-hypointense, T2-/fluid-attenuated inversion recovery-hyperintense pineal region mass with cerebral aqueduct obstruction and hydrocephalus. She underwent placement of a right extraventricular drain followed by complete surgical resection. Histologic analysis was consistent with IPEH.
CONCLUSIONS: Although rare, IPEH is an entity that should be considered in the differential diagnosis for intracranial masses with radiographic features characteristic of vascular lesions. Tissue sampling is imperative for distinction from more malignant entities. Complete resection is curative and is the standard of care when feasible. Given the risk of local progression and neurologic compromise with subtotal resection of central nervous system lesions, further study regarding adjuvant treatment options is warranted.
Author List
Retzlaff AA, Arispe K, Cochran EJ, Zwagerman NTAuthors
Elizabeth J. Cochran MD Adjunct Professor in the Pathology department at Medical College of WisconsinNathan Zwagerman MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultBrain Neoplasms
Drainage
Female
Humans
Hyperplasia
Magnetic Resonance Imaging
Neurosurgical Procedures
Pineal Gland
Treatment Outcome
Vascular Neoplasms
