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Intracranial papillary endothelial hyperplasia (Masson’s tumour) following gamma knife radiosurgery for temporal lobe epilepsy
  1. Andrew W Barritt1,
  2. Ashirwad Merve2,
  3. Prasanna Epaliyanage1,
  4. Julia Aram1
  1. 1Department of Neurology, Hurstwood Park Neurosciences Centre, Haywards Heath, UK
  2. 2Neuropathology, National Hospital for Neurology and Neurosurgery, London, UK
  1. Correspondence to Dr Andrew W Barritt, Department of Neurology, Hurstwood Park Neurosciences Centre, Princess Royal Hospital, Haywards Heath, West Sussex RH16 4EX, UK; awb{at}doctors.org.uk

Abstract

We present a rare case of intracranial papillary endothelial hyperplasia, or ‘Masson’s tumour,’ following gamma knife radiosurgery for epilepsy. A 59-year-old woman presented with a 4-month history of escalating headaches and progressive neurological deficit. MR scan of brain showed enlargement of an enhancing right temporal lobe lesion, midline shift and obstructive hydrocephalus. She had previously undergone non-curative gamma knife radiosurgery at the age of 44 years for medically refractory complex partial seizures. Postprocedure imaging had shown signal change and enhancement within the right temporal lobe consistent with radiation necrosis, which remained stable over the next decade. Now, 15 years following radiosurgery, we suspected an intrinsic high-grade neoplasm, but surgical excision instead found a benign pseudoneoplasm. Papillary endothelial hyperplasia should be considered in the differential diagnosis for mass lesions following gamma knife radiosurgery, particularly as resection can be curative. Remarkably, she has become seizure free.

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