RARE-09SYMPTOMATIC XANTHOGRANULOMA OF THE LATERAL VENTRICLE: CASE REPORT AND LITERATURE REVIEW

Abstract

INTRODUCTION: Intracranial xanthogranulomas (XG) describe a rare benign histiocytic neoplasm classically found incidentally in adults. They are characterized by infiltration of xanthomatous and spindle to scalloped shaped histiocytic cells with surrounding inflammatory components. To the best of our knowledge, there are15prior reported cases in the literature of symptomatic XG of the lateral ventricle. CASE: A 25-year-old female pregnant at 13 weeks presented with complaints of headaches and altered sensation to an outside hospital. Magnetic resonance imaging (MRI) showed a heterogeneous lesion of the lateral ventricle with no associated hydrocephalus. The patient was referred to our clinic and underwent transcortical resection following the completion of her pregnancy. Histopathology demonstrated xanthochromatous CD68 positive histiocytes and foreign body giant cells within a fibrous capsule indicative of XG. At present, the patient is at 4-years post surgery and is doing very well without evidence of recurrence. CONCLUSION: While intracranial lesions are mostly incidental, XG have the potential to become symptomatic in both children and adults through mass effect or obstructive hydrocephalus. The majority of suchlesions are thus found incidentally on imaging, on post-mortemexamination or autopsy. The clinical and radiological features of XG are often undistinguishable from tumors arising in the choroid plexus. As such, XG should be considered as a rare etiology in the differential of both newly diagnosed intraventricular lesions.