Fibro-osseous lesions of the central nervous system: report of four cases and literature review

Am J Surg Pathol. 1999 Oct;23(10):1270-5. doi: 10.1097/00000478-199910000-00013.

Abstract

Fibro-osseous lesions, also reported as calcifying pseudoneoplasms of the neural axis, are uncommon lesions of the CNS. We report four additional cases: two extraaxial and two intraaxial, in patients ages 33, 47, 49, and 59 years at presentation. Fibro-osseous lesions involving the CNS demonstrate variable proportions of fibrous stroma, bone, palisading spindle to epithelioid to multinucleated cells in association with a highly distinctive, perhaps pathognomonic, chondromyxoid-like matrix often distributed in a nodular pattern. This histopathologically distinctive lesion can be seen in many regions of the neuraxis, often with a dural association, and most commonly along the vertebral column. It appears to be a slow-growing lesion and, with wide excision, the prognosis is excellent. The etiology remains unclear, but the preponderance of data favors a reactive rather than neoplastic process. If this putative pseudotumor is not recognized histopathologically, a neoplastic or infectious differential might result in inappropriate investigations and potentially harmful therapies.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Biomarkers, Tumor / metabolism
  • Calcinosis / metabolism
  • Calcinosis / pathology*
  • Calcinosis / surgery
  • Cartilage / pathology
  • Central Nervous System Diseases / metabolism
  • Central Nervous System Diseases / pathology*
  • Central Nervous System Diseases / surgery
  • Female
  • Granuloma / metabolism
  • Granuloma / pathology*
  • Granuloma / surgery
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Treatment Outcome

Substances

  • Biomarkers, Tumor