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Papers of the Week

2022 Dec

Asian J Neurosurg



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


Fotakopoulos G, Brotis AG, Paterakis K, Kapsalaki E, Fountas KN
Asian J Neurosurg. 2022 Dec; 17(4):680-682.
PMID: 36570746.


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.