CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(04): 680-682
DOI: 10.1055/s-0042-1757433
Case Report

Posterior Fossa Intra-Axial Lesion: There Are Pathologies Beyond Metastases

George Fotakopoulos
1   Department of Neurosurgery, General University Hospital of Larissa, Larissa, Greece
,
Alexandros G. Brotis
1   Department of Neurosurgery, General University Hospital of Larissa, Larissa, Greece
,
Konstantinos Paterakis
1   Department of Neurosurgery, General University Hospital of Larissa, Larissa, Greece
,
Eftychia Kapsalaki
2   Department of Radiology, University of Thessaly, Medical School of Thessaly, Thessaly, Greece
,
Kostas N. Fountas
1   Department of Neurosurgery, General University Hospital of Larissa, Larissa, Greece
› Author Affiliations
Funding None.

Abstract

Cerebellar metastases represent the most common lesion requiring surgical treatment in the daily neurosurgical praxis. We report a rare case with Lhermitte–Duclos disease presenting to the neurosurgical outpatient department and describe our diagnostic and treatment challenges. A 57-year-old man presented with transient cerebellar manifestations, including walking difficulties, dizziness, and a persistent occipital headache. The magnetic resonance imaging demonstrated a high-intensity lesion in the right cerebellar hemisphere on T2-weighted images. We initially considered surgery to establish a histopathological diagnosis. However, the magnetic resonance spectroscopy was compatible with a dysplastic gangliocytoma of the cerebellum. Therefore, we preferred a more conservative approach. Posterior fossa contrast-enhancing lesions are much more than metastases. The role of advanced magnetic resonance in avoiding unnecessary surgical interventions is priceless.

Ethical Approval

The study was approved by the institutional ethics committee.




Publication History

Article published online:
29 October 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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