P. Celli et al., An asymptomatic hypertrophic pacchionian granulation simulating osteolyticlesion of the calvaria, NEUROSURG R, 22(2-3), 1999, pp. 149-151
Osteolytic lesions can be seen in various diseases. We present a rare case
of symptomatic hypertrophic pacchionian granulation mimicking bone tumor in
the calvaria. A 50-year-old woman suffered from a previous VII cranial ner
ve peripheral paresis accompanied by headache. A plain radiograph revealed
a punched-out paramedial occipital lesion. Precontrast-enhanced computed to
mographic scans demonstrated a hypodense mass, with a defect of both tables
of the left occipital bone. Magnetic resonance imaging (MRI) demonstrated
a hypointense mass on the T1-weighted image and isointense to cerebrospinal
fluid on the T2-weighted image, with capsule-like contrast enhancement by
gadolinium. A biopsy was performed. Histologically, hypertrophic pacchionia
n granulation was diagnosed. The patient has had no growth for 2 years. Thi
s case suggests the need to include hypertrophic pacchionian granulation in
the differential diagnosis of punched-out lesions.