Histiocytic lesion mimicking intrinsic brainstem neoplasm. Case report

J Neurosurg. 1999 Dec;91(6):1037-40. doi: 10.3171/jns.1999.91.6.1037.


This 10-year-old girl presented with a 1-month history of progressive bulbar palsy and a solitary enhancing mass originating within the floor of the fourth ventricle. Results of initial imaging studies and presentation were suggestive of neoplasia. Subtotal resection was performed and pathological examination revealed the mass to be a histiocytic lesion, with no evidence of a glioma. The patient had no other stigmata of histiocytosis and was treated with steroid medications, resulting in prolonged resolution of the lesion. This case demonstrates that for discrete brainstem lesions the differential diagnosis includes entities other than glioma for which treatment is available. Biopsy sampling should be considered when technically feasible.

Publication types

  • Case Reports

MeSH terms

  • Brain Diseases / diagnosis
  • Brain Diseases / pathology
  • Brain Diseases / surgery*
  • Brain Stem Neoplasms / diagnosis
  • Brain Stem Neoplasms / pathology
  • Brain Stem Neoplasms / surgery*
  • Bulbar Palsy, Progressive / etiology
  • Bulbar Palsy, Progressive / pathology
  • Bulbar Palsy, Progressive / surgery
  • Cerebral Ventricles / pathology
  • Cerebral Ventricles / surgery
  • Child
  • Diagnosis, Differential
  • Female
  • Histiocytosis / diagnosis
  • Histiocytosis / pathology
  • Histiocytosis / surgery*
  • Humans
  • Magnetic Resonance Imaging