Calcified mass on brain CT in a teenager with refractory seizures

Mahmoud Reza Khalatbari, Enrico Brunetti, Elham Shobeiri, Yashar Moharamzad

Research output: Contribution to journalArticlepeer-review

Abstract

Cerebral echinococcosis is very rare, representing 2% of all cystic echinococcosis (CE) cases. Primary echinococcal cysts of the brain are extremely rare in pediatric patients. We report on a 16-year-old boy referred to our tertiary center with intractable epilepsy for the previous three years despite receiving full doses of three antiepileptic medications. Brain computed tomography (CT) showed a left frontal calcified mass. Magnetic resonance imaging (MRI) of the brain revealed a well-defined spherical mass in the left frontal lobe, slightly hypointense on T1-weighted and heterogeneous hyperintense on T2-weighted images with no contrast enhancement. With a broad differential list in mind, a surgical intervention was planned. During surgery, a primary calcified cerebral echinococcal cyst with severe adhesion to the adjacent dura of the frontal region was discovered and removed intact. Histopathology examination confirmed the diagnosis. Only phénobarbital was continued and no medical therapy for CE was administered. Two years after surgery, the patient remained free of seizures. In areas endemic for CE, cerebral echinococcal cyst should be included in the differential list of patients with intractable seizures. Though rare, this entity can present itself as a calcified mass on neuroimaging. Surgical removal of the calcified cyst is necessary for control and treatment of the epilepsy.

Original languageEnglish
Pages (from-to)691-696
Number of pages6
JournalNeuroradiology Journal
Volume27
Issue number6
DOIs
Publication statusPublished - Dec 1 2014

Keywords

  • Adolescent
  • Calcified hydatid cyst
  • Cerebral calcification
  • Cerebral hydatid cyst
  • Echinococcus
  • Refractory seizures

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

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