A unique case of primary central nervous system neuroblastoma mimicking as hemangiopericytoma in an adult

Abstract

Neuroblastoma is one of the common pediatric malignancy. Its occurrence in adult patients is a rareness in itself. Intrabdominal location is the most common site of the tumor, however intracranial manifestation is a very infrequent and unusual finding. We report 1 such unique and rare case of a 25 year old, female patient, who presented with chief complaints of on and off headache, occasional vomiting and blurring of vision. Plain CT brain study followed by CEMRI brain study showed a well- defined extra axial lesion in right frontal region, showing predominantly homogenous enhancement and few non enhancing area. The lesion was causing focal erosion of right frontal bone also. Imaging differentials were concluded as hemangiopericytoma, atypical meningioma with rare possibilities of histiocytosis and dural metastases. The patient underwent right frontal craniotomy with gross excision of the mass. The final histopathological conclusion came as supratentorial neuroblastoma. Subsequent chest and abdomen radiographs and ultrasound abdomen of the patient showed no obvious evidence of any intrathoracic or intrabdominal mass or vertebral lesion. Our case, therefore, is a unique amalgamation of both rare age presentation and infrequent location for Neuroblastoma. It also emphasizes on the pertinence and relevance of correlation among imaging findings, differentials and finally the histopathological results. Although, adult primary intracranial neuroblastoma is a very rare occurrence, but a radiologist should be aware of such sparse entities which can be encountered occasionally and mimic other commoner and known intracranial aetiologies on imaging.