Brain Pathology Case of the Month - February 2002

Contributed by Kar-Ming Fung1, MD, PhD, Jason M Schwalb2, MD, Howard A Riina, MD2, Jasvir S Kurana1, MD, Justina M Mindaxy1, MS, M Sean Grady1, MD, Ehud Lavi1, MD
  1Department of Pathology and Laboratory Medicine, Division of Neuropathology Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
2Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Published on line in February 2002


LL was 29 year-old Asian woman who sustained a minor hit of her head on the closet two months prior. There was neither loss of consciousness nor laceration during the incident. She developed progressively increased swelling over her left frontal bone over the course of two months. At presentation, the swelling was 4 cm in diameter and was neither tender nor warm. Physical examination was otherwise unremarkable and she was neurologically intact. CT scan revealed an osteolytic lesion (Figure 1) with an overlying soft tissue mass (Figure 2) consistent with an unhealed skull fracture and pseudomeningocele.

A left frontal craniotomy was performed. A large blood-filled soft tissue mass was encountered over the skull defect. This mass extended through a 1.5cm defect in the skull and was adherent to the dura. The bone edges appeared to be invaded by the mass. Gross total resection was performed followed by a methylmethacrylate cranioplasty.



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