An unusual diagnosis of a dural based intracranial lesion

Abstract

A 19-year old man was referred to the Haematology clinic of a large tertiary hospital in Melbourne, Australia, with an 8-month history of cervical lymphadenopathy, non-drenching night sweats, and unintentional weight loss of 30 kg. His past medical history includes depression and regular marijuana use. He had been recently diagnosed with epilepsy, after presenting to hospital with a first seizure 3 months prior to this presentation. He did not undergo any intracranial imaging at that time. Clinical examination revealed obvious palpable non-tender asymmetric cervical and parotid lymphadenopathy. Neurological examination was unremarkable. Gadolinium-enhanced MRI Brain demonstrated a 44 × 26 × 41 mm left temporal extra-axial lesion (see Fig. 1). What is the most likely diagnosis?A.LymphomaB.Rosai-Dorfman diseaseC.MeningiomaD.HaemangiopericytomaE.SarcoidosisF.ChondrosarcomaG.Epidural abscess Answer on page 285. The authors have no conflicts of interest or sources of support to declare. An unusual diagnosis of a dural based intracranial lesionJournal of Clinical NeuroscienceVol. 66PreviewRosai-Dorfman disease, or sinus histiocytosis with massive lymphadenopathy, is a rare illness that classically manifests with massive, widespread, painless cervical lymphadenopathy [1]. It has a prevalence of 1:200 000 and approximately 100 new cases are diagnosed each year in the United States [2]. It is frequently diagnosed in children and young adults (mean age 20.6 years) [3], predominantly in males (M:F ratio of 1.8:1) [4]. Extranodal disease is a feature of 43% of cases, with central nervous system (CNS) involvement in <5% of cases, and over 300 cases of CNS involvement reported in the literature [5]. Full-Text PDF