SYMPTOMATIC HYPERTROPHIC PACCHIONIAN GRANULATION MIMICKING BONE-TUMOR- CASE-REPORT

OBJECTIVE AND IMPORTANCE: Osteolytic lesions can be seen in various di seases, and they also resemble the markings normally found on the cran ium. We present a rare case of symptomatic hypertrophic pacchionian gr anulation mimicking bone tumor in the calvaria. CLINICAL PRESENTATION: A 46-year-old woman suffered from a small hump accompanied by pain in the right frontoparietal region. A plain radiograph revealed two punc hed-out lesions. Precontrast-enhanced computed tomographic scans demon strated hypodense masses, with partial defect of the outer table of th e cranium. Magnetic resonance imaging demonstrated hypointense masses in the T1-weighted image and hyperintense masses in the TZ-weighted im age, with capsule-like contrast enhancement by gadolinium diethylenetr iamine penta-acetic acid. INTERVENTION: The masses were totally resect ed with attached bone and dura. One of them had destroyed the outer ta ble of the cranium. The affected portions of the masses lacked the dur a and partially adhered to the brain surface. Histologically, hypertro phic pacchionian granulation was diagnosed. CONCLUSION: The patient ha s had no recurrence for 2 years. This case suggests the need to includ e hypertrophic pacchionian granulation in the differential diagnosis o f punched-out lesions.