Plasma Cell Granulomas of the Central Nervous System

Abstract

Plasma cell granulomas of the central nervous system are rare benign forms of inflammatory pseudotumor of unknown etiology. They are often characterized by nonneoplastic proliferation of plasma cells and mimicking neoplastic processes. The author describes the management of six patients with histological proven plasma cell granulomas presented primarily with headache. Three were males with their age ranged from 9 to 43 years and a mean follow up of 40 months. The preoperative imaging studies revealed 3 cases located in the cerebral convexity and 3 were located in the posterior fossa region. Craniotomy was performed in 5 patients and in three patients complete resection was achieved. The resection was subtotal in 2 patients and they received postoperative steroids and radiation therapy. Complete resolution of the residual lesion was observed in one, and in another, the residual lesion remained stable during follow-up. One patient with infiltrating petroclival lesions had image-guided trans-nasal biopsy followed by radiation therapy with partial response. The author reviewed the literature of this rare entity and identified 46 reported cases of plasma cell granulomas. The clinicopathological and radiological findings, and the differential diagnoses were discussed and the management was outlined.