A Rare Intradural Extramedullary Calcifying Pseudoneoplasm of the Spine Presenting with Radiculopathy

Abstract

Aims: Calcifying pseudoneoplasms of the neuroaxis (CPN) are rare, poorly understood lesions of the central nervous system that pose a diagnostic challenge because they mimic the more common calcified lesions of the neuroaxis. We highlight the relevant clinical presentation as well as radiological and histopathological features unique to intraspinal CPNs. Presentation of Case: We present the case of a 44-year-old Hispanic male with lumbar radiculopathy, radiological features of an indolent, intradural extramedullary mass, and a histopathological evaluation consistent with CPN. The patient underwent successful surgical resection and remained neurologically intact at long-term follow-up. Discussion: Epidural CPNs have been described in the literature. However, intradural CPNs are exceedingly rare lesions, and as a result, are not routinely included in the differential diagnosis of calcified, intraspinal lesions. Although there are currently no consensus guidelines for the diagnosis and management of intraspinal CPNs, understanding the clinical presentation and radiological features of these lesions is crucial for spine surgeons and neurosurgeons because surgical resection may offer a cure. Conclusion: Calcifying pseudoneoplasms may present as intradural abnormalities that mimic more prevalent lesions such as meningiomas. Surgical resection should be considered as first-line treatment because it is associated with low morbidity and may be potentially curative.